Advances in Methods and Novel Applications for Measuring Family Spillover Effects of Illness

Prosser, Lisa A.; Wittenberg, Eve

doi:10.1007/s40273-019-00794-5

Cited by 23 publications

(19 citation statements)

References 23 publications

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“…For example, CEAs of interventions for Alzheimer’s disease or a pediatric population are more likely to include both types of spillover effects than the overall literature, but spillover health effects were considered substantially less often than spillover costs [ 56 , 57 ]. Recent advances in methodology and applications for measuring and valuing spillover effects have provided a set of useful resources for analysts to incorporate the spillover effects into CEAs from both a healthcare sector and a societal perspective [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018

et al. 2020

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Objective Our objective was to examine perspective and costing approaches used in cost-effectiveness analyses (CEAs) and the distribution of reported incremental cost-effectiveness ratios (ICERs). Methods We analyzed the Tufts Medical Center’s CEA and Global Health CEA registries, containing 6907 cost-per-quality-adjusted-life-year (QALY) and 698 cost-per-disability-adjusted-life-year (DALY) studies published through 2018. We examined how often published CEAs included non-health consequences and their impact on ICERs. We also reviewed 45 country-specific guidelines to examine recommended analytic perspectives. Results Study authors often mis-specified or did not clearly state the perspective used. After re-classification by registry reviewers, a healthcare sector or payer perspective was most prevalent (74%). CEAs rarely included unrelated medical costs and impacts on non-healthcare sectors. The most common non-health consequence included was productivity loss in the cost-per-QALY studies (12%) and patient transportation in the cost-per-DALY studies (21%). Of 19,946 cost-per-QALY ratios, the median ICER was $US26,000/QALY (interquartile range [IQR] 2900–110,000), and 18% were cost saving and QALY increasing. Of 5572 cost-per-DALY ratios, the median ICER was $US430/DALY (IQR 67–3400), and 8% were cost saving and DALY averting. Based on 16 cost-per-QALY studies (2017–2018) reporting 68 ICERs from both the healthcare sector and societal perspectives, the median ICER from a societal perspective ($US22,710/QALY [IQR 11,991–49,603]) was more favorable than from a healthcare sector perspective ($US30,402/QALY [IQR 10,486–77,179]). Most governmental guidelines (67%) recommended either a healthcare sector or a payer perspective. Conclusion Researchers should justify and be transparent about their choice of perspective and costing approaches. The use of the impact inventory and reporting of disaggregate outcomes can reduce inconsistencies and confusion.

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Section: Discussionmentioning

confidence: 99%

Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018

et al. 2020

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“…Especially in countries with tight financial and capacity constraints in their health and social care sectors, and which face ageing populations, informal care is an indispensable part of the total care provided to people in need [2,3]. It has therefore been advocated to include the effects of interventions on informal caregivers in policy decision-making and (economic) evaluations of health and social care interventions [4,5]. Such inclusion can have a significant impact on cost-effectiveness of health and social care interventions [6].…”

Section: Introductionmentioning

confidence: 99%

Validation of the Hungarian version of the CarerQol instrument in informal caregivers: results from a cross-sectional survey among the general population in Hungary

et al. 2020

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Purpose The CarerQol instrument has been designed and validated as an instrument able to measure both the positive and the negative impacts of caregiving on the quality of life of informal caregivers (CarerQol-7D), as well as their general happiness (CarerQol-VAS). The aim of this study was to assess the construct validity of the CarerQol in the Hungarian context. Methods The CarerQol was translated into Hungarian. Subsequently, in a cross-sectional online survey, representative for the general Hungarian population (N = 1000), informal caregivers were identified (N = 149, female 51.2%, mean age 53.2). Clinical, convergent and discriminant validity of the CarerQol were evaluated in relation to the caregivers’ and care recipients’ EQ-5D-5L health status, and caregiving situation characteristics. Results Average CarerQol-7D and CarerQol-VAS scores were 76.0 (SD 16.2) and 6.8 (SD 2.3), respectively. CarerQol-7D and CarerQol-VAS scores were significantly correlated with caregiving time (r = − 0.257; − 0.212), caregivers’ EQ-5D-5L scores (r = 0.453; 0.326) and the CarerQol-7D also with care recipients’ EQ-5D-5L scores (r = 0.247). CarerQol-7D scores differed significantly with relevant caregiving characteristics (e.g. nature and severity of care recipients’ health status, sharing household) and both the CarerQol-7D and CarerQol-VAS with the overall care experience. Conclusion Our findings confirmed the validity of the Hungarian language version of the CarerQol and support the cross-cultural validity of the instrument. CarerQol-7D scores performed better in distinguishing caregiving situation characteristics than the general happiness measure CarerQol-VAS. Care recipients’ health status was only weakly associated with informal caregivers’ care-related quality of life and happiness. Caregivers’ own health and caregiving circumstances were more strongly associated with these scores.

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“…The issue of measuring and valuing benefits for children and adolescents cannot be considered in isolation, since the impact of ill-health reaches wider than the child or adolescent to other family members. There is an important literature around the use of a family perspective in economic evaluation for children and adolescents to include spillover effects and also around joint utility estimation [5,[8][9][73][74][75][76] and this is an area that deserves consideration by international agencies when they consider whether to make special recommendations around measuring and valuing health benefits in child and adolescent populations for economic evaluation.…”

Section: Discussionmentioning

confidence: 99%