1
|
Archer-Kuhn B, Lind C, Beltrano N, Garrisen L, Hettler J, Reilly S. Realizing an Evidence-Based Framework for the Management and Delivery of Family Support Services. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:455-473. [PMID: 38288721 DOI: 10.1080/26408066.2024.2310599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
PURPOSE This paper reports on how service providers and academic researchers partnered to support the journey of a primary prevention organization in western Canada as they reviewed their programming against an evidence-based practice (EBP) framework. The process allows the organization to increase their EBP culture by encouraging staff understanding and uptake of their nine family support programs. It also informs service users and other stakeholders of the evidentiary status of different kinds of support services. In this way, the families become more informed and engaged partners who might easily evaluate the respective risks and benefits of the various applications. METHOD As part of the process, an evidence-based framework used a common language to assess the efficacy of the respective nine programs. RESULTS All nine programs are now mapped into the EBP framework. CONCLUSIONS This review allows staff to become more intentional and informed about the EBPs they employ to support vulnerable families and to use this knowledge to better inform the families with whom they work. This paper and the process the agency followed can be a model for other organizations who serve families experiencing short-term housing crisis, provide infant nursery care, and other support services for families with young children.
Collapse
Affiliation(s)
- Beth Archer-Kuhn
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Candace Lind
- Faculty of Nursing, University of Calgary, Calgary, Canada
| | - Natalie Beltrano
- School of Social Work, University of Windsor, Windsor, ON, Canada
| | - Lisa Garrisen
- of Programs, Children's Cottage Society, Calgary, AB, Canada
| | | | | |
Collapse
|
2
|
Le DQ, Le LKD, Le PH, Yap MBH, Mihalopoulos C. Cost effectiveness of interventions to prevent the occurrence and the associated economic impacts of child maltreatment: A systematic review. CHILD ABUSE & NEGLECT 2024:106863. [PMID: 38816302 DOI: 10.1016/j.chiabu.2024.106863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/01/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Child maltreatment is a pressing public health concern that poses long-lasting health and economic impacts on children and society. While several preventive interventions have demonstrated their effectiveness in reducing the occurrence of child maltreatment and its associated economic impacts, the cost-effectiveness of such interventions remains unclear. OBJECTIVE This study aims to provide a comprehensive overview and a narrative synthesis of the available economic evidence on child maltreatment preventive interventions in both high-income and low-middle-income countries. METHOD Systematic searches were conducted in MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, and Econlit to identify full economic evaluations and return-on-investment studies on child maltreatment preventive interventions. The methodological quality of eligible studies was assessed using Drummond's 10-point checklist. This review adhered to the PRISMA guidelines, and summarized findings in a narrative synthesis. RESULTS Twenty-six studies met the inclusion criteria. Of these, eight evaluated home visiting, four evaluated early childhood education (ECE), four assessed multi-component (MC), and three examined group-based parent education (GPE) interventions. The remaining studies assessed interventions to prevent abusive head trauma (AHT; n = 2), child sexual abuse (n = 2), physical abuse at school (n = 1), as well as individualized intensive parenting (IIP; n = 2), and counseling (n = 1) interventions. Two studies were conducted in low-middle-income countries, while the others were all in high-income countries. CONCLUSIONS The included studies generally exhibited high methodological quality. Only AHT, ECE, IIP, and MC interventions demonstrated promising cost-effectiveness credentials in preventing child maltreatment. More economic evaluations are needed for interventions with mixed findings (e.g. GPE) and in low-middle-income countries.
Collapse
Affiliation(s)
- Dai Quy Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Long Khanh-Dao Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Phuong Hong Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Marie Bee Hui Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
3
|
Mendoza-Jiménez MJ, van Exel J, Brouwer W. On spillovers in economic evaluations: definition, mapping review and research agenda. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-023-01658-8. [PMID: 38261132 DOI: 10.1007/s10198-023-01658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024]
Abstract
An important issue in economic evaluations is determining whether all relevant impacts are considered, given the perspective chosen for the analysis. Acknowledging that patients are not isolated individuals has important implications in this context. Increasingly, the term "spillovers" is used to label consequences of health interventions on others. However, a clear definition of spillovers is lacking, and as a result, the scope of the concept remains unclear. In this study, we aim to clarify the concept of spillovers by proposing a definition applicable in health economic evaluations. To illustrate the implications of this definition, we highlight the diversity of potential spillovers through an expanded impact inventory and conduct a mapping review that outlines the evidence base for the different types of spillovers. In the context of economic evaluations of health interventions, we define spillovers as all impacts from an intervention on all parties or entities other than the users of the intervention under evaluation. This definition encompasses a broader range of potential costs and effects, beyond informal caregivers and family members. The expanded impact inventory enables a systematic approach to identifying broader impacts of health interventions. The mapping review shows that the relevance of different types of spillovers is context-specific. Some spillovers are regularly included in economic evaluations, although not always recognised as such, while others are not. A consistent use of the term "spillovers", improved measurement of these costs and effects, and increased transparency in reporting them are still necessary. To that end, we propose a research agenda.
Collapse
Affiliation(s)
- María J Mendoza-Jiménez
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands.
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands.
- Facultad de Ciencias Sociales y Humanísticas, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador.
| | - Job van Exel
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Werner Brouwer
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
4
|
Kugener T, Wiethoff I, van Mastrigt G, van den Berg B, Evers SMAA. Economic evaluations of interventions focusing on child abuse and neglect in high-income countries: a systematic review. Front Psychiatry 2023; 14:1031037. [PMID: 37415695 PMCID: PMC10320140 DOI: 10.3389/fpsyt.2023.1031037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/24/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Child abuse and neglect are together considered to be an important public health problem with a high individual and societal burden. Different interventions have been developed to prevent, diagnose, or treat maltreatment. While their effectiveness has been synthesized in prior reviews, the analysis of their cost-effectiveness is less common. The aim of this study is to synthesize and analyse economic evaluations of interventions focusing on child abuse and neglect in high-income countries. Methods A systematic literature review was performed using MEDLINE, EMBASE, EconLit, PsycInfo and NHS EED. This study follows the PRISMA guidelines and double scoring was performed. The review includes trial- and model-based economic evaluations of preventive, diagnostic, and treatment related interventions in children up to 18 years or their caregivers. Risk of bias was assessed using the CHEC-extended checklist. The results are presented in a cost-effectiveness plane. Results Of 5,865 search results, the full texts of 81 were analyzed, resulting in the inclusion of 11 economic evaluations. Eight of the included studies focus on prevention of child abuse and neglect, one study on diagnosis, and two on treatment. The heterogeneity between studies did not allow for the quantitative pooling of results. Most interventions were cost-effective, with the exception of one preventive and one diagnostic intervention. Conclusion This study was subject to some limitations, as no gray literature was included, and the selection of studies may have been arbitrary due to varying terminologies and methodologies in the field. However, the quality of studies was high, and several interventions showed promising results. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021248485, identifier: CRD42021248485.
Collapse
Affiliation(s)
- Tom Kugener
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Isabell Wiethoff
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Ghislaine van Mastrigt
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Bram van den Berg
- Department of Quality, Policy and Monitoring, Nederlands Jeugdinstituut, Utrecht, Netherlands
| | - Silvia M. A. A. Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Centre for Economic Evaluation and Machine Learning, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| |
Collapse
|
5
|
Ha NT, Huong NT, Anh VN, Anh NQ. Modelling in economic evaluation of mental health prevention: current status and quality of studies. BMC Health Serv Res 2022; 22:906. [PMID: 35831821 PMCID: PMC9281039 DOI: 10.1186/s12913-022-08206-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background The present study aimed to identify and critically appraise the quality of model-based economic evaluation studies in mental health prevention. Methods A systematic search was performed on MEDLINE, EMBASE, EconLit, PsycINFO, and Web of Science. Two reviewers independently screened for eligible records using predefined criteria and extracted data using a pre-piloted data extraction form. The 61-item Philips Checklist was used to critically appraise the studies. Systematic review registration number: CRD42020184519. Results Forty-nine studies were eligible to be included. Thirty studies (61.2%) were published in 2015–2021. Forty-seven studies were conducted for higher-income countries. There were mainly cost-utility analyses (n = 31) with the dominant primary outcome of quality-adjusted life year. The most common model was Markov (n = 26). Most of the studies were conducted from a societal or health care perspective (n = 37). Only ten models used a 50-year time horizon (n = 2) or lifetime horizon (n = 8). A wide range of mental health prevention strategies was evaluated with the dominance of selective/indicate strategy and focusing on common mental health problems (e.g., depression, suicide). The percentage of the Philip checkilst’s criteria fulfilled by included studies was 69.3% on average and ranged from 43.3 to 90%. Among three domains of the Philip checklist, criteria on the model structure were fulfilled the most (72.1% on average, ranging from 50.0% to 91.7%), followed by the data domain (69.5% on average, ranging from 28.9% to 94.0%) and the consistency domain (54.6% on average, ranging from 20.0% to 100%). The practice of identification of ‘relevant’ evidence to inform model structure and inputs was inadequately performed. The model validation practice was rarely reported. Conclusions There is an increasing number of model-based economic evaluations of mental health prevention available to decision-makers, but evidence has been limited to the higher-income countries and the short-term horizon. Despite a high level of heterogeneity in study scope and model structure among included studies, almost all mental health prevention interventions were either cost-saving or cost-effective. Future models should make efforts to conduct in the low-resource context setting, expand the time horizon, improve the evidence identification to inform model structure and inputs, and promote the practice of model validation. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08206-9.
Collapse
Affiliation(s)
- Nguyen Thu Ha
- Department of Health Policy and Economics, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Thanh Huong
- Department of Health Education and Promotion, Hanoi University of Public Health, Hanoi, Vietnam.
| | | | - Nguyen Quynh Anh
- Department of Health Policy and Economics, Hanoi University of Public Health, Hanoi, Vietnam
| |
Collapse
|
6
|
Scheuer H, Kuklinski MR, Sterling SA, Catalano RF, Beck A, Braciszewski J, Boggs J, Hawkins JD, Loree AM, Weisner C, Carey S, Elsiss F, Morse E, Negusse R, Jessen A, Kline-Simon A, Oesterle S, Quesenberry C, Sofrygin O, Yoon T. Parent-focused prevention of adolescent health risk behavior: Study protocol for a multisite cluster-randomized trial implemented in pediatric primary care. Contemp Clin Trials 2022; 112:106621. [PMID: 34785305 PMCID: PMC8802622 DOI: 10.1016/j.cct.2021.106621] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/01/2021] [Accepted: 11/09/2021] [Indexed: 01/03/2023]
Abstract
Evidence-based parenting interventions play a crucial role in the sustained reduction of adolescent behavioral health concerns. Guiding Good Choices (GGC) is a 5-session universal anticipatory guidance curriculum for parents of early adolescents that has been shown to reduce substance use, depression symptoms, and delinquent behavior. Although prior research has demonstrated the effectiveness of evidence-based parenting interventions at achieving sustained reductions in adolescent behavioral health concerns, public health impact has been limited by low rates of uptake in community and agency settings. Pediatric primary care is an ideal setting for implementing and scaling parent-focused prevention programs as these settings have a broad reach, and prevention programs implemented within them have the potential to achieve population-level impact. The current investigation, Guiding Good Choices for Health (GGC4H), tests the feasibility and effectiveness of implementing GGC in 3 geographically and socioeconomically diverse large integrated healthcare systems. This pragmatic, cluster randomized clinical trial will compare GGC parenting intervention to usual pediatric primary care practice, and will include approximately 3750 adolescents; n = 1875 GGC intervention and n = 1875 usual care. The study team hypothesizes that adolescents whose parents are randomized into the GGC intervention arm will show reductions in substance use initiation, the study's primary outcomes, and other secondary (e.g., depression symptoms, substance use prevalence) and exploratory outcomes (e.g., health services utilization, anxiety symptoms). The investigative team anticipates that the implementation of GGC within pediatric primary care clinics will successfully fill an unmet need for effective preventive parenting interventions. Trial registration: Clinicaltrials.govNCT04040153.
Collapse
Affiliation(s)
- Hannah Scheuer
- Social Development Research Group, School of Social Work, University of Washington, 9725 Third Ave. NE, Suite 401, Seattle, WA 98115, USA.
| | - Margaret R Kuklinski
- Social Development Research Group, School of Social Work, University of Washington, 9725 Third Ave. NE, Suite 401, Seattle, WA 98115, USA.
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Richard F Catalano
- Social Development Research Group, School of Social Work, University of Washington, 9725 Third Ave. NE, Suite 401, Seattle, WA 98115, USA.
| | - Arne Beck
- Institute for Health Research, Kaiser Permanente Colorado, 2550 S. Parker Rd, Suite 200, Aurora, CO 80014, USA.
| | - Jordan Braciszewski
- Center for Health Policy and Health Services Research, Henry Ford Health System, 1 Ford Place, Suite 3A, Detroit, MI 48202, USA.
| | - Jennifer Boggs
- Institute for Health Research, Kaiser Permanente Colorado, 2550 S. Parker Rd, Suite 200, Aurora, CO 80014, USA.
| | - J David Hawkins
- Social Development Research Group, School of Social Work, University of Washington, 9725 Third Ave. NE, Suite 401, Seattle, WA 98115, USA.
| | - Amy M Loree
- Center for Health Policy and Health Services Research, Henry Ford Health System, 1 Ford Place, Suite 3A, Detroit, MI 48202, USA.
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Susan Carey
- Social Development Research Group, School of Social Work, University of Washington, 9725 Third Ave. NE, Suite 401, Seattle, WA 98115, USA.
| | - Farah Elsiss
- Center for Health Policy and Health Services Research, Henry Ford Health System, 1 Ford Place, Suite 3A, Detroit, MI 48202, USA.
| | - Erica Morse
- Institute for Health Research, Kaiser Permanente Colorado, 2550 S. Parker Rd, Suite 200, Aurora, CO 80014, USA.
| | - Rahel Negusse
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Andrew Jessen
- Institute for Health Research, Kaiser Permanente Colorado, 2550 S. Parker Rd, Suite 200, Aurora, CO 80014, USA.
| | - Andrea Kline-Simon
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Sabrina Oesterle
- Southwest Interdisciplinary Research Center, 201 N. Central Ave., 33rd Floor, Phoenix, AZ 85004, USA.
| | - Charles Quesenberry
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Oleg Sofrygin
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Tae Yoon
- Center for Health Policy and Health Services Research, Henry Ford Health System, 1 Ford Place, Suite 3A, Detroit, MI 48202, USA.
| |
Collapse
|
7
|
Bailey C, Skouteris H, Morris H, O'Donnell R, Hill B, Ademi Z. Economic evaluation methods used in home-visiting interventions: A systematic search and review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1650-1667. [PMID: 33761181 DOI: 10.1111/hsc.13349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 02/07/2021] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
Home-visiting interventions are used to improve outcomes for families experiencing disadvantage. As scarce resources must be allocated carefully, appropriate methods are required to provide accurate information on the effect of these programmes. We aimed to investigate: economic evaluation/analysis methods used in home-visiting programmes for children, young people and families, study designs and methods suitable in situations where randomised-controlled-trials are not feasible, and type of costs included in analyses, including any implementation costs stated. A systematic search and review was conducted of existing full economic evaluation/analysis methods in home-visiting programmes for children, young people and/or families. We included studies published in English between January 2000 and mid-November 2020. Of the 4,742 papers sourced, 60 were retained for full-text review, and 21 included. Economic-analysis methods found in the included studies were: within trial economic evaluation, economic evaluation using decision analytic modelling (i.e. cost-utility, cost-benefit analysis), cost comparison and cost-consequence. Studies incorporating return on investment and budget impact analysis were also found. Study designs suitable when randomisation was not feasible included parallel cluster randomised trials and using pre-post intervention data. Costs depended mainly on study context and only one study reported implementation costs. We hope this information will help guide future economic evaluations of home-visiting interventions.
Collapse
Affiliation(s)
- Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Warwick Business School, Warwick University, Coventry, Australia
| | - Heather Morris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Renee O'Donnell
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|
8
|
Oxford ML, Hash JB, Lohr MJ, Bleil ME, Fleming CB, Unützer J, Spieker SJ. Randomized trial of promoting first relationships for new mothers who received community mental health services in pregnancy. Dev Psychol 2021; 57:1228-1241. [PMID: 34591567 DOI: 10.1037/dev0001219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The effectiveness of Promoting First Relationships (PFR), a 10-week home visiting program with video feedback, was tested in a randomized controlled trial involving 252 mothers and their 8- to 12-week-old infants. Mothers were eligible if they initiated treatment after mental health screening (depression, anxiety, posttraumatic stress disorder [PTSD]) at a community or public health primary care center in pregnancy. At baseline, 51% had mild to severe depression symptoms, 54% had mild to severe anxiety, and 35% had PTSD. Their ages ranged from 18 to 42 years. Mothers were 66% White, 18% Black, and 16% other races. Forty-seven percent identified as Hispanic, and 33% preferred to read and speak in Spanish. The median family annual income was less than $20,000. The PFR program or receipt of a resource packet (control condition) followed the baseline assessment and randomization; we assessed outcomes when infants were age 6 and 12 months. Compared to mothers in the control condition, mothers in the PFR condition had significantly (ps < .05) higher observed sensitivity scores at both follow-up time points (d = .25, d = .26), had improved understanding of infant-toddler social-emotional needs at both time points (d = .21, d = .45), and reported less infant externalizing behavior at age 12 months (d = .28). This study is the fourth completed randomized controlled trial of the PFR program, all involving populations experiencing adversity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Monica L Oxford
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Jonika B Hash
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Mary J Lohr
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Maria E Bleil
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Charlie B Fleming
- Department of Child, Family, and Population Health Nursing, University of Washington
| | - Jurgen Unützer
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Susan J Spieker
- Department of Child, Family, and Population Health Nursing, University of Washington
| |
Collapse
|
9
|
Pokhilenko I, Janssen LMM, Evers SMAA, Drost RMWA, Schnitzler L, Paulus ATG. Do Costs in the Education Sector Matter? A Systematic Literature Review of the Economic Impact of Psychosocial Problems on the Education Sector. PHARMACOECONOMICS 2021; 39:889-900. [PMID: 34121169 PMCID: PMC8298334 DOI: 10.1007/s40273-021-01049-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Psychosocial (e.g., anxiety or behavior) problems lead to costs not only in the healthcare sector but also in education and other sectors. As psychosocial problems develop during the critical period of establishing educational trajectories, education costs are particularly relevant in the context of psychosocial problems among children and adolescents. OBJECTIVES This study aimed to gain insights into the methods used for the inclusion of education costs in health economics studies and into the proportion of the education costs in relation to the total costs associated with a condition or an intervention. METHODS We systematically searched the PubMed, Embase, SSCI, CINAHL, PsycINFO, ERIC, and Econlit databases in August 2019 for economic evaluations of mental health, psychosocial and educational interventions, and cost-of-illness studies of mental, behavioral, and neurodevelopmental disorders conducted from a societal perspective in populations of children and adolescents. An additional search was conducted in February 2021 to update the review. RESULTS In total, 49 articles were included in the analysis. The most common cost items were special education, school absenteeism, and various educational professionals (educational psychologist). A variety of methods were employed for the identification, measurement, and/or valuation of education costs. The proportion of education costs to the total costs of condition/intervention ranged from 0 to 67%, with the mean being 18.5%. DISCUSSION Since education costs can constitute a significant proportion of the total costs of an intervention or condition, including them in health economics studies might be important in informing optimal resource allocation decisions. Although various methods are available for including education costs in health economics studies, further research is needed to develop evidence-based methods for producing comparable estimates.
Collapse
Affiliation(s)
- Irina Pokhilenko
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Luca M M Janssen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Silvia M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Centre for Economic Evaluation and Machine Learning, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ruben M W A Drost
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Lena Schnitzler
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Health Economics Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Aggie T G Paulus
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Faculty of Health Medicine and Life Sciences, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|