The value of health economics research in spinal cord injury

Whitehurst, David G. T.; Mittmann, Nicole

doi:10.1038/sc.2013.47

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…The development of a national body (akin to the Ontario SCI Solutions Alliance and its member organizations) to routinely lobby and advocate for changes in health policy are essential to the future of rehabilitation services enhancements. There are many inequities and challenges associated with bringing about policy change for individuals with a relatively rare disease, such as SCI, compared to individuals with larger scale, common diseases (e.g., diabetes, cancer) [19]. One example of the challenges associated with generating policy change for persons with SCI is the difficulty of conducting clinical trials, health policy analysis, and economic evaluations with a population that has low incidence, but high prevalence and cost, to inform enhancements in provincial and or national services.…”

Section: Get Policy Smartmentioning

confidence: 99%

The Tipping Point: Perspectives on SCI Rehabilitation Service Gaps in Canada

Craven

Balioussis²,

Verrier³

2013

Int J Phys Med Rehabil

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Section: Get Policy Smartmentioning

confidence: 99%

The Tipping Point: Perspectives on SCI Rehabilitation Service Gaps in Canada

Craven

Balioussis²,

Verrier³

2013

Int J Phys Med Rehabil

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“…Increasing support for economic evaluation within a cost-utility framework, where health benefits are quantified using the quality-adjusted life year (QALY) metric, has ensured that preference-based health-related quality of life (HRQoL) instruments have been the focus of extensive psychometric evaluation across a broad range of clinical conditions and community-based samples. Spinal cord injury (SCI) is one clinical area that has not received this level of attention from the outcomes measurement or health economics research communities [1]. …”

Section: Introductionmentioning

confidence: 99%

Perceptions of individuals living with spinal cord injury toward preference-based quality of life instruments: a qualitative exploration

Whitehurst

Suryaprakash

Engel

et al. 2014

Health and Quality of Life Outcomes

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BackgroundGeneric preference-based health-related quality of life instruments are widely used to measure health benefit within economic evaluation. The availability of multiple instruments raises questions about their relative merits and recent studies have highlighted the paucity of evidence regarding measurement properties in the context of spinal cord injury (SCI). This qualitative study explores the views of individuals living with SCI towards six established instruments with the objective of identifying ‘preferred’ outcome measures (from the perspective of the study participants).MethodsIndividuals living with SCI were invited to participate in one of three focus groups. Eligible participants were identified from Vancouver General Hospital’s Spine Program database; purposive sampling was used to ensure representation of different demographics and injury characteristics. Perceptions and opinions were solicited on the following questionnaires: 15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index (HUI), Quality of Well-Being Scale Self-Administered (QWB-SA), and the SF-36v2. Framework analysis was used to analyse the qualitative information gathered during discussion. Strengths and limitations of each questionnaire were thematically identified and managed using NVivo 9 software.ResultsMajor emergent themes were (i) general perceptions, (ii) comprehensiveness, (iii) content, (iv) wording and (v) features. Two sub-themes pertinent to content were also identified; ‘questions’ and ‘options’. All focus group participants (n = 15) perceived the AQoL-8D to be the most relevant instrument to administer within the SCI population. This measure was considered to be comprehensive, with relevant content (i.e. wheelchair inclusive) and applicable items. Participants had mixed perceptions about the other questionnaires, albeit to varying degrees.ConclusionsDespite a strong theoretical underpinning, the AQoL-8D (and other AQoL instruments) is infrequently used outside its country of origin (Australia). Empirical comparative analyses of the favoured instruments identified in this qualitative study are necessary within the context of spinal cord injury.

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“…However, there is a paucity of evidence related to health preference or QALYs after SCI, and further work is needed. 13,14 In the absence of data, work to relate appropriate measures of health outcomes in the SCI population may be mapped onto health preference values. One suitable outcome measure is the International Classification of Functioning, Disability and Health (ICF), which is the endorsed framework of the World Health Organization for measuring health and disability at both the individual and population levels.…”

mentioning

confidence: 99%

Predicting health preference in chronic spinal cord injury

Mittmann¹,

Hitzig

Craven³

2014

The Journal of Spinal Cord Medicine

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Context/Objective: Health preference values relate to a person's state of well-being, and is a single metric anchored at 0 (death) and 1 (perfect health). Health preference plays a key role in health economics and health policy, particularly in interpreting the results of cost-effectiveness studies, and supports the allocation of healthcare resources. The current study used elements of the International Classification of Functioning, Disability and Health (ICF) framework to predict health preference in persons with spinal cord injury (SCI). Methods: Data were collected by telephone survey on (1) demographics, (2) impairment (etiology, neurological level of injury, and ASIA impairment scale), (3) secondary health conditions (SHCs) using the SCI-Secondary Conditions Scale-Modified, (4) functional abilities using the Spinal Cord Independence Measure (SCIM), and (5) health preference using the Health Utilities Index-Mark III (HUI-Mark III) among adults with chronic SCI. Variables were categorized according to ICF headings and hierarchical regression analyses were used to predict HUI-Mark III scores. Results: Adults with chronic traumatic or non-traumatic SCI (N = 357) reported a mean health preference score of 0.27 (±0.27). In predicting health preference, our model accounted for 55.1% of the variance with "body functions and structure", and "activity and participation", significantly contributing to the model (P < 0.0001). In particular, older age, being employed, and having higher SCIM scores were positively associated with health preference. Conversely, a higher SHC impact score was associated with poorer health preference. Conclusions: Variables representative of "activity and participation" largely influence health preference among persons with chronic SCI, which may be amenable to intervention. These findings could be applied to advocate for health promotion and employment support programs to maximize well-being in persons aging with chronic SCI in the community.

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The value of health economics research in spinal cord injury

Cited by 7 publications

References 4 publications

The Tipping Point: Perspectives on SCI Rehabilitation Service Gaps in Canada

The Tipping Point: Perspectives on SCI Rehabilitation Service Gaps in Canada

Perceptions of individuals living with spinal cord injury toward preference-based quality of life instruments: a qualitative exploration

Predicting health preference in chronic spinal cord injury

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