Is a family equal to the sum of its parts? Estimating family-level well-being for cost-effectiveness analysis

Abstract

Cost-effectiveness (CEA) analysis of health interventions focuses primarily on individual-level costs and benefits. However, health interventions intended for individuals often have implications for other members of an individual's family and the overall functioning of the family. While researchers have assessed the effects of health interventions on multiple family members, CEA has not routinely incorporated measures of effectiveness or costs from multiple family members. We could imagine, however, that CEA might over- or under-estimate the effects of health interventions if they are limited to individuals targeted by the intervention. Family-level CEA would consider the well-being of and costs borne by multiple family members in response to an individual-level intervention, and potentially lead to more appropriate resource allocation. Using the health plan as a working frame of reference, we explore conceptual issues related to estimating effectiveness at the level of the family for use in CEA.

Afetividade e conflito familiar e sua relação com a depressão em crianças e adolescentes

“…The objective of this research was to investigate the psychometrics properties of the Familiogram, and the association of the results of affectivity and family conflict with the intensity of depressive symptoms in children and adolescents. Two hundred thirty four students participated of the study (133 female, 56.8%) and their ages ranged from 8 to 14 years old A família inclui, em um sentido mais básico, parentes com ligações sanguíneas ou pessoas ligadas por casamento, união estável ou adoção, em que os membros cooperam economicamente, cuidam das crianças ou consideram sua identidade como sendo intimamente conectada (Bonomi, Boudreau, Fishman, Meenan, & Revicki, 2005;Schneewind, 1999). Em um sentido mais amplo, este grupo incorpora a conexão com os indivíduos dentro de sua comunidade histórica, geográfica e sócio-cultural.…”

The determinants of household-level well-being in Northern Ghana

“…Research shows that parents' health condition can directly affect their children's health condition and use of health services (Olfson et al 2003). Several studies have modeled wellbeing on a family level for estimating the cost-effectiveness (CEA) of health interventions (Bonomi et al 2005). Bonomi et al (2005) delineated conceptual issues involved in representing the effects of health interventions at the family level.…”

“…Several studies have modeled wellbeing on a family level for estimating the cost-effectiveness (CEA) of health interventions (Bonomi et al 2005). Bonomi et al (2005) delineated conceptual issues involved in representing the effects of health interventions at the family level. While measuring family-level assessments of CEA can be challenging, Bonomi et al (2005) pointed out that data collected from multiple family members could be aggregated and analyzed into a family-level indicator.…”

“…Bonomi et al (2005) delineated conceptual issues involved in representing the effects of health interventions at the family level. While measuring family-level assessments of CEA can be challenging, Bonomi et al (2005) pointed out that data collected from multiple family members could be aggregated and analyzed into a family-level indicator. To the best of the authors' knowledge, however, none of the previous studies on wellbeing have modeled the collective household-level physical well-being as an underlying construct resulting from the interaction of individual members in the household.…”

Fan-family conflict : an examination of inter-role conflict between sport fan and family roles.

“…Therefore, it is important to clarify how family will be operationalized. From a healthcare perspective, Bonomi, Boudreau, Fishman, Meenan, and Revicki (2005) defined family as "adults linked by marriage or partnership, and their biological or adopted children" (p. 1128). This definition is limited however in that it does not allow for family members or close friends who fall outside of the parent/child relationship.…”