PurposeThe aim of this paper is to report results of the impact of the information and communication technology (ICT) platform and telecare services developed by the MonAMI consortium on the quality of life (QOL) of older people in three European communities.Design/methodology/approachIn a three‐month trial, the MonAMI technology was installed in the homes of older people with various needs, in the cities of Stockholm, Sweden; Zaragoza, Spain; and Kosice, Slovakia. Evaluation criteria and instrumentation were developed to assess the effects of the services on users' perceived QOL in the domains of independence, physical health, psychological wellbeing, social networking, and physical environment.FindingsA total of 62 users, with a mean age of 79 years, participated in the trial. Results demonstrate that the MonAMI services had some positive, significant effects on users' QOL. For instance, users with a higher number of disabilities at baseline reported greater confidence in keeping intruders from entering their home compared to users with fewer disabilities (OR=2.51, 0.01 p<0.05). However, overall findings show that healthier, more independent users perceived more benefits from the services compared to users who report more health problems and are less independent.Research limitations/implicationsThe complexities of conducting the MonAMI trial led to a small, heterogeneous sample of users over a short time span. This in turn created difficulties in observing the potential effects of the services and achieving significance on some indicators of QOL.Originality/valueThis paper provides quantitative analyses around the impact of telecare services; suggests important directions for further research; and highlights the methodological challenges of evaluating ICT‐based care services in a community setting.

The dominant rule of economic evaluation within health care posits that resources are distributed in order to maximize health benefit. There are instances, however, where the public has demonstrated that they do not prefer such an allocation scheme, particularly in the context of life-saving interventions. Objectives: Deviations from preferences of maximizing health benefit have important implications on both financial and distributive levels. This study sought to specify the circumstances in which respondent preferences are inconsistent with maximizing health benefit. Methods: Ninety respondents recruited from the London School of Economics and Political Science completed a questionnaire comprised of a series of paired profiles involving various combinations of life-saving or quality-of-life enhancing interventions. Results:The results indicate that saving a life holds value beyond that captured by traditional health benefit measurement and that the value of saving a life is not consistent across ages. More specifically, the value of saving a life was agedependent and markedly attenuated for older-age patients. Conclusions: Many respondents were willing to overlook maximizing health benefit in order to rescue a life in immediate peril, and showed a diminished sense of moral imperative to rescue older-age patients. In light of difficulties related to the implementation of larger-scale policies incorporating Rule of Rescue concerns, the most realistic approaches will likely involve adopting smaller-scale policies that address issues such as do not resuscitate (DNRs) and living wills. Potential policy solutions such as age or monetary thresholds for life-saving interventions may be favoured in a research context; however, their overall social feasibility is questionable.In healthcare, as in virtually every public sector, resources are limited and must therefore be rationed. It is a matter of fact that there are insufficient resources (specifically, funds available) to provide optimal treatment to every individual. 1 If demand for healthcare exceeds the supply of resources (namely, the funds available), then methods by which available resources are distributed must be determined. This involves prioritizing what programs or interventions are funded and who (which patients) are eligible beneficiaries. 2 Currently, several health systems use the qualityadjusted life-year (QALY) in economic evaluations whereby efficiency is attained by reaching 'greatest health gain per amount spent.' The QALY is a composite measure of health benefit, incorporating both quantity (life-years gained) and quality (health-related quality-of-life) from treatment, enabling comparisons of health care programs with different types of outcomes from various domains within health care. 3,4 When paired with the cost of the intervention, the resulting cost per QALY ratio can provide guidance on the economic efficiency of respective interventions.

This report addresses the question of whether there are financial benefits to acquiring transportation right of way far in advance of when the improvement will be done. The first part of the analysis is very general, comparing rates of price increase for different types of properties to the opportunity costs of holding land, over a long historical period. The second part of the analysis focuses on Minnesota and examines property price increases by county over shorter, more recent, time periods.

Introduction: There are widespread concerns around the accessibility of mainstream technology which remains underdeveloped for the needs of many older people 1. The Mainstreaming on Ambient Intelligence (MonAMI) project 2, funded under the EU FP6 framework in the area of e-Inclusion, developed an open technology platform and series of 'telecare' services designed to be accessed using mainstreamed devices (e.g. mobile telephones, personal computers). A field trial was conducted to evaluate the technology in the homes of disabled older people in three communities across Europe.

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