Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs: What Broader Non-Health Outcomes Matter Most?

Abstract

BackgroundAttention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of non-health outcomes in a health promotion context.MethodWe investigated the relative importance of ten non-health outcomes of health promotion programs not commonly captured in QALYs. Preferences were elicited from a sample of the Dutch general public (N = 549) by means of a ranking task. These preferences were analyzed using Borda scores and rank-ordered logit models.ResultsThe relative order of preference (from most to least important) was: self-confidence, insights into own (un)healthy behavior, perceived life control, knowledge about a certain health problem, social support, relaxation, better educational achievements, increased labor participation and work productivity, social participation, and a reduction in criminal behavior. The weight given to a particular non-health outcome was affected by the demographic variables age, gender, income, and education. Furthermore, in an open question, respondents mentioned a number of other relevant non-health outcomes, which we classified into outcomes relevant for the individual, the direct social environment, and for society as a whole.ConclusionThe study provides valuable insights in the non-health outcomes that are considered as most important by the Dutch general population. Ideally, researchers should include the most important non-health outcomes in economic evaluations of health promotion.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0908-y) contains supplementary material, which is available to authorized users.

A qualitative study on the views of experts regarding the incorporation of non-health outcomes into the economic evaluations of public health interventions

“…This study confirms the findings of two other studies within our research group - one investigating the view of the Dutch public in general [ 30 ], and another, a systematic review on the use of NHOs for the evaluation of PH interventions in the Netherlands [van Mastrigt GAPG, Alayli-Goebbels AFG, Lawson KD, Evers SMAA. Identifying non-health outcomes of health promotion for consideration in economic evaluations from a societal perspective Submitted ].…”

“…Identifying non-health outcomes of health promotion for consideration in economic evaluations from a societal perspective Submitted] were also mentioned headings by our experts. These NHO headings were, respectively, “self-confidence”, “(un) healthy behavior”, “perceived life control”, “social life”, “educational achievements”, “employability”, “participation and integration”, and “justice and security” [ 30 ]. Two others mentioned by Benning et al, “knowledge about a certain health problem” and “relaxation” were not frequently mentioned by the experts.…”

Measuring Wellbeing in a Healthcare Setting: a Qualitative Study of Staff and Service User Perspectives

“…Furthermore, if the same wellbeing questionnaire is utilised by different providers and the resultant data made publically available, benchmarking between providers becomes possible. This has positive implications for facilitating patient choice when comparing between and selecting a health care provider (Benning et al 2015;Ettorchi-Tardy et al 2012;Lee et al 2013).…”

The impact of health vs. non-health goals on individuals’ lifestyle program choices: a discrete choice experiment approach

“…There is an increasing attention in the economic welfare literature for incorporating broader aspects of consumer evaluations such as happiness and wellbeing into economic evaluations [29,30]. Similar broader perspectives are also being investigated in public health economics [26][27][28]. In the context of lifestyle programs, non-health aspects of interventions can also be relevant for individuals, as they may choose to participate in programs for other reasons than health alonewhich is closely related to the goal-based decisions that we investigate in the present study [35].…”

“…For most individuals, this promotes choosing the alternative that is most consistent with the goal [25]. Because of the fact that the attention on incorporating broader outcome measures into economic evaluations is increasing [26][27][28][29][30], we specifically investigate the effect of presenting non-health versus health goals. This distinction between non-health and health goals also plays an important role in the case of lifestyle programs [22].…”