Aspects and Challenges of Resource Use Measurement in Health Economics: Towards a Comprehensive Measurement Framework

Janssen, Luca M. M.; Drost, Ruben M. W. A.; Paulus, Aggie; Garfield, Kirsty; Hollingworth, William; Noble, Sian; Thorn, Joanna; Pokhilenko, Irina; Evers, Silvia M. A. A.

doi:10.1007/s40273-021-01048-z

Cited by 15 publications

(11 citation statements)

References 57 publications

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“…The final IBD-RUQ includes 102 items in 6 categories, with a recall period of 3 months. It is well known that longer recall periods are subject to errors of omissions and under-reporting while a shorter recall period can result in missing out on rare but expensive events 28. We opted for a 3-month recall period as likely optimal in the context of a chronic condition such as the IBD 29.…”

Section: Resultsmentioning

confidence: 99%

Development and test–retest reliability of a new, self-report questionnaire assessing healthcare use and personal costs in people with inflammatory bowel disease: the Inflammatory Bowel Disease Resource Use Questionnaire (IBD-RUQ)

Roukas

Syred

Gordeev

et al. 2022

Frontline Gastroenterol

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Background and aimsThe increasing prevalence of inflammatory bowel disease (IBD) poses a substantial economic burden globally on health systems and societies. Validated instruments to collect data on healthcare and other service utilisation by patients with IBD are lacking. We developed a self-report patient questionnaire to capture key resource utilisation from health services, patient and societal perspectives.MethodsThe IBD Resource Use Questionnaire (IBD-RUQ), developed by a multidisciplinary team, including patients, comprises 102 items across the six categories of outpatient visits, diagnostics, medication, hospitalisations, employment and out-of-pocket expenses over the past three months. The test–retest reliability of the IBD-RUQ was studied by administering it twice among patients with IBD with a 2-week time gap. The intraclass correlation coefficients and the average cost from the healthcare, societal and patient perspectives, between test and retest assessments, overall and by service category, were summarised.ResultsThe IBD-RUQ captures health service use, employment and out-of-pocket expenses. Of 55 patients who completed the first questionnaire, 48 completed the retest questionnaires and were included in the analyses. Test–retest reliability for categories of medications, diagnostics, specialist outpatient and inpatient services, and days off work due to IBD ranged from moderate to excellent; primary care visits showed more limited reliability. The annualised average self-reported health service, out-of-pocket and loss of productivity costs were £4844, £320 and £545 per patient, respectively.ConclusionsThe IBD-RUQ is a reliable and valid self-report measure of resource utilisation in adults with IBD and can be used to measure costs associated with IBD.

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Section: Resultsmentioning

confidence: 99%

Development and test–retest reliability of a new, self-report questionnaire assessing healthcare use and personal costs in people with inflammatory bowel disease: the Inflammatory Bowel Disease Resource Use Questionnaire (IBD-RUQ)

Roukas

Syred

Gordeev

et al. 2022

Frontline Gastroenterol

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“…While the literature was not able to provide clear-cut recommendations, the overview of challenges of measuring resource use in economic evaluations guided the methodological decisions made in step 4. More details about the scoping review are available elsewhere [ 48 ]. Development of a Harmonized Methodological Approach …”

Section: Methodsmentioning

confidence: 99%

Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM

Pokhilenko

Janssen

Paulus

et al. 2023

Appl Health Econ Health Policy

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Background Measuring objective resource-use quantities is important for generating valid cost estimates in economic evaluations. In the absence of acknowledged guidelines, measurement methods are often chosen based on practicality rather than methodological evidence. Furthermore, few resource-use measurement (RUM) instruments focus on the measurement of resource use in multiple societal sectors and their development process is rarely described. Thorn and colleagues proposed a stepwise approach to the development of RUM instruments, which has been used for developing cost questionnaires for specific trials. However, it remains unclear how this approach can be translated into practice and whether it is applicable to the development of generic self-reported RUM instruments and instruments measuring resource use in multiple sectors. This study provides a detailed description of the practical application of this stepwise approach to the development of a multisectoral RUM instrument developed within the ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) project. Methods For the development of the PECUNIA RUM, the methodological approach was based on best practice guidelines. The process included six steps, including the definition of the instrument attributes, identification of cost-driving elements in each sector, review of methodological literature and development of a harmonized cross-sectorial approach, development of questionnaire modules and their subsequent harmonization. ResultsThe selected development approach was, overall, applicable to the development of the PECUNIA RUM. However, due to the complexity of the development of a multi-sectoral RUM instrument, additional steps such as establishing a uniform methodological basis, harmonization of questionnaire modules and involvement of a broader range of stakeholders (healthcare professionals, sector-specific experts, health economists) were needed. Conclusion This is the first study that transparently describes the development process of a generic multi-sectoral RUM instrument in health economics and provides insights into the methodological aspects and overall validity of its development process.The members of the PECUNIA Group are mentioned in Acknowledgments section.

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“…The study collected ILD-related healthcare utilization for the previous 6 months at enrollment into the registry and at routine visits by means of a physician-based questionnaire. Using resource use measurement methodologies [13], we defined outpatient care as the number of outpatient visits to an ILD expert physician and inpatient care as the number of days a patient was admitted to a hospital. Other therapies included costs attributed to rehabilitation or physiotherapy.…”

Section: Healthcare Utilization and Costsmentioning

confidence: 99%

Costs of Pharmacological and Non-Pharmacological Interventions in Interstitial Lung Disease Management in Germany

et al. 2022

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Introduction: Interstitial lung diseases (ILDs) are associated with a high economic burden, yet prospective data of the German healthcare system are sparse. Objective: We assessed average ILD-related costs of pharmacological and non-pharmacological (hospitalizations, outpatient, rehabilitation, physiotherapy, and medical aids) interventions in ILD. Methods: We used data from the multicenter, observational, prospective Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases registry to evaluate adjusted per capita costs and cost drivers for ILD-related healthcare costs over 4 years, using generalized estimating equation regression models. Results: Idiopathic pulmonary fibrosis (IPF) had the highest annual pharmacological costs >EUR 21,000, followed by connective tissue disease-associated ILD (CTD-ILD) averaging EUR 6,000. Other idiopathic interstitial pneumonias and hypersensitivity pneumonitis averaged below EUR 2,400 and sarcoidosis below EUR 400. There were no significant differences in pharmacological costs over time. Trends in non-pharmacological costs were statistically significant. At year 1, CTD-ILD had the highest costs (EUR 7,700), while sarcoidosis had the lowest (EUR 2,547). By year 4, these declined to EUR 3,218 and EUR 232, respectively. Regarding cost drivers, the ILD subtype had the greatest impact with 75 times higher pharmacological costs in IPF and 4 times higher non-pharmacological costs in CTD-ILD, compared to the reference. Pulmonary hypertension (PH) and gastroesophageal reflux disease (GERD) triggered higher pharmacological costs, and higher values of forced vital capacity % predicted were associated with lower pharmacological and non-pharmacological costs. Conclusion: Stabilizing lung function and reducing the impact of PH and GERD are crucial in reducing the economic burden of ILD. There is an urgent need for effective treatment options, especially in CTD-ILD.

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Aspects and Challenges of Resource Use Measurement in Health Economics: Towards a Comprehensive Measurement Framework

Cited by 15 publications

References 57 publications

Development and test–retest reliability of a new, self-report questionnaire assessing healthcare use and personal costs in people with inflammatory bowel disease: the Inflammatory Bowel Disease Resource Use Questionnaire (IBD-RUQ)

Development and test–retest reliability of a new, self-report questionnaire assessing healthcare use and personal costs in people with inflammatory bowel disease: the Inflammatory Bowel Disease Resource Use Questionnaire (IBD-RUQ)

Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM

Costs of Pharmacological and Non-Pharmacological Interventions in Interstitial Lung Disease Management in Germany

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