Health Economic Evaluation of the Psychiatric Emergency Response Team (PAM) in Stockholm County

2020 ◽  
Author(s):  
Andreas Carlborg ◽  
Rainer Sibbel ◽  
Magnus Helgesson
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Human Capital ◽  
Economic Evaluation ◽  
Stockholm County ◽  
Total Cost ◽  
Human Value ◽  
Friction Cost ◽  
Response Team ◽  
Production Losses

Abstract Background: The Psychiatric Response Team (the PAM unit) started as a suicide prevention project during the spring of 2015 to handle acute psychiatric patients previously handled by the police. Since 2017, the PAM has been a permanent service within the health care organization of Stockholm County. Method: Health economic estimates, based on different scenarios, were designed to investigate the economic evaluation of the PAM unit from both a health-care and a societal perspective. Another aim was to present an economic model that can be applied and developed in future studies to evaluate suicide-prevention projects. Potential savings achieved by the PAM unit were examined by measuring direct and indirect costs based on three different scenarios: restrictive, likely and optimistic. Costs were compared to the potential savings from changes in processes using the PAM unit. Estimates of potential savings from production losses were made using the friction-cost and human-capital methods. An estimate of human value was made using figures from previous studies in traffic-injury prevention. Different theoretical health economic methods of calculation are presented. Results: Total cost for the PAM unit during its first two years of operation was 13.2 million Swedish kronor (SEK). Comparatively, direct savings from a health-care perspective were estimated at 2.8-5.1 million SEK, while direct savings from a societal perspective were estimated at 5.9-10.6 million SEK. The estimate of indirect savings differs depending on approach adopted: from 1.0-1.5 million SEK (friction-cost) to 52.0-103.9 million SEK (human-capital). Further, if estimates of human value are included, there are additional savings ranging from 52.3 to 82.1 million SEK. Conclusion: The direct cost saving of the PAM unit, estimated on different scenarios, does not make it viable from a purely economic perspective. However, there are large indirect cost savings from avoidance of future production losses and savings in human value. The rescuing of a single patient from suicide by the PAM unit during one year would, under most estimated scenarios, justify the total cost of the intervention.

PD85 Testing Search Filters To Retrieve Economic Evaluations In Embase

2018 ◽  
Vol 34 (S1) ◽  
pp. 158-158
Author(s):  
Ingrid Harboe ◽  
Arna Desser ◽  
Lena Nordheim ◽  
Julie Glanville
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Economic Evaluation ◽  
Health Care Services ◽  
Evidence Base ◽  
Bibliographic Databases ◽  
Economic Evaluations ◽  
Care Services ◽  
Health Authorities ◽  
Search Filters

Introduction:Health technology assessments (HTAs) are increasingly used by Norwegian health authorities as the evidence base when prioritizing which health care services to offer. HTAs typically consist of a systematic review of the effects and safety of two or more health care interventions, and an economic evaluation of the interventions, based on systematic literature searches in bibliographic databases. Objective: To identify the best performing of seven search filters to retrieve health economic evaluations used to inform HTAs, by comparing the cost-effectiveness analysis (CEA) filter to six published filters in Ovid Embase, and achieve a sensitivity of at least 0.90 with a precision of 0.10, and specificity of at least 0.95.Methods:In this filter validation study, the included filters’ performances were compared against a gold standard of economic evaluations published in 2008–2013 (n = 2,248) from the National Health Service Economic Evaluation Database (NHS EED), and the corresponding records (n = 2,198) in the current version of Ovid Embase.Results:The CEA filter had a sensitivity of 0.899 and precision of 0.029. One filter had a sensitivity of 0.880 and a precision of 0.075, which was closest to the objective. The filter with lowest sensitivity (0.702) had a precision of 0.141.Conclusions:Developing search filters for identifying health economic evaluations, with a good balance between sensitivity and precision, is possible but challenging. Researchers should agree on acceptable levels of performance before concluding on which search filter to use.

scholarly journals Sustainability of Community-Based Specialized Mental Health Services in Five European Countries: Protocol for Five Randomized Controlled Trial–Based Health-Economic Evaluations Embedded in the RECOVER-E Program (Preprint)

2019 ◽  
Author(s):  
Ben F M Wijnen ◽  
Filip Smit ◽  
Ana Ivičević Uhernik ◽  
Ana Istvanovic ◽  
Jovo Dedovic ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Economic ◽  
Economic Evaluation ◽  
Mental Health Services ◽  
Health Services ◽  
Health Economic Evaluation ◽  
Community Based ◽  
Care Costs ◽  
Specialized Mental Health

BACKGROUND Community-based recovery-oriented mental health services for people with severe mental disorders have not been fully implemented in Bulgaria, Croatia, Macedonia, Montenegro, and Romania. The RECOVER-E project facilitates the implementation of specialized mental health care delivered by setting up services, implementing the services, and evaluating multidisciplinary community mental health teams. The outcomes of the RECOVER-E project are assessed in a trial-based outcome evaluation in each of the participating countries with a health-economic evaluation linked to these trials. OBJECTIVE The aim of this protocol paper is to describe the methodology that will be used for the health-economic evaluation alongside the trials. METHODS Implementation sites have been selected in each of the five countries where hospital-based mental health services are available (care as usual [CAU]) for patients with severe mental disorders (severe depression, bipolar disorder, schizophrenia, and other psychotic disorders). The newly implemented health care system will involve community-based recovery-oriented mental health care (CMHC). At each site, 180 consenting patients will be randomized to either CAU or CMHC. Patient-level outcomes are personal and social functioning and quality-adjusted life years (QALYs). Data on participants’ health care use will be collected and corresponding health care costs will be computed. This enables evaluation of health care costs of CMHC as compared with CAU, and these costs can be related to patient-level outcomes (functioning and QALY gains) in health-economic evaluation. RESULTS Data collection was started in December 2018 (Croatia), February 2019 (Montenegro), April 2019 (Romania), June 2019 (North Macedonia), and October 2019 (Bulgaria). The findings of the outcome evaluations will be reported for each of the five countries separately, and the five trials will be pooled for multilevel analysis on a combined dataset. CONCLUSIONS The results of the health-economic evaluation of the RECOVER-E project will contribute to the growing evidence base on the health and economic benefits of recovery-oriented and community-based service models for health systems in transition. CLINICALTRIAL (1) ClinicalTrials.gov NCT03922425 (Bulgaria); https://clinicaltrials.gov/ct2/show/NCT03922425 (2) ClinicalTrials.gov NCT03862209 (Croatia); https://clinicaltrials.gov/ct2/show/NCT03862209 (3) ClinicalTrials.gov NCT03892473 (Macedonia); https://clinicaltrials.gov/ct2/show/NCT03892473 (4) ClinicalTrials.gov NCT03837340 (Montenegro); https://clinicaltrials.gov/ct2/show/NCT03837340 (5) ClinicalTrials.gov NCT03884933 (Romania); https://clinicaltrials.gov/ct2/show/NCT03884933 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17454

STRUCTURE FOR ECONOMIC EVALUATIONS

2013 ◽  
Vol 29 (2) ◽  
pp. 115-116 ◽  
Author(s):  
Marjukka Mäkelä ◽  
Harri Sintonen
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Economic Evaluation ◽  
Task Force ◽  
Health Economic Evaluation ◽  
Economic Evaluations ◽  
Delphi Panel ◽  
Reporting Standards ◽  
Modified Delphi ◽  
Item Checklist

Guidelines for reporting economic evaluations in health care are very welcome. A task force of the International Society for Pharmacoeconomics and Outcomes Research has organized a two-round, modified Delphi Panel process to compile a set of recommendations for reporting Consolidated Health Economic Evaluation Reporting Standards. The result is a 24-item checklist with the friendly acronym CHEERS (1), published in this issue of the International Journal of Technology Assessment in Health Care.

scholarly journals Health economic assessment of a scenario to promote bicycling as active transport in Stockholm, Sweden

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030466 ◽  
Author(s):  
Hedi Katre Kriit ◽  
Jennifer Stewart Williams ◽  
Lars Lindholm ◽  
Bertil Forsberg ◽  
Johan Nilsson Sommar
Keyword(s):  
Physical Activity ◽  
Health Economic ◽  
Air Pollution ◽  
Economic Evaluation ◽  
Active Transport ◽  
Healthcare Costs ◽  
Cost Effective ◽  
Stockholm County ◽  
Air Pollution Exposure ◽  
Pollution Exposure

ObjectivesTo conduct a health economic evaluation of a proposed investment in urban bicycle infrastructure in Stockholm County, Sweden.DesignA cost-effectiveness analysis is undertaken from a healthcare perspective. Investment costs over a 50-year life cycle are offset by averted healthcare costs and compared with estimated long-term impacts on morbidity, quantified in disability-adjusted life years (DALYs). The results are re-calculated under different assumptions to model the effects of uncertainty.SettingThe Municipality of Stockholm (population 2.27 million) committed funds for bicycle path infrastructure with the aim of achieving a 15% increase in the number of bicycle commuters by 2030. This work is based on a previously constructed scenario, in which individual registry data on home and work address and a transport model allocation to different modes of transport identified 111 487 individuals with the physical capacity to bicycle to work within 30 min but that currently drive a car to work.ResultsMorbidity impacts and healthcare costs attributed to increased physical activity, change in air pollution exposure and accident risk are quantified under the scenario. The largest reduction in healthcare costs is attributed to increased physical activity and the second largest to reduced air pollution exposure among the population of Greater Stockholm. The expected net benefit from the investment is 8.7% of the 2017 Stockholm County healthcare budget, and 3.7% after discounting. The economic evaluation estimates that the intervention is cost-effective and each DALY averted gives a surplus of €9933. The results remained robust under varied assumptions pertaining to reduced numbers of additional bicycle commuters.ConclusionInvesting in urban infrastructure to increase bicycling as active transport is cost-effective from a healthcare sector perspective.

scholarly journals A systematic review of health economic evaluation of targeted therapies for first-line treatment of metastatic non-small cell lung cancer (NSCLC): Quality evaluation

2019 ◽  
Author(s):  
Jie Zhao ◽  
Shuzhang Du ◽  
Yan Liang ◽  
Hongchao Li ◽  
Feng Chang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Health Economic ◽  
Economic Evaluation ◽  
Small Cell Lung Cancer ◽  
Targeted Therapies ◽  
Health Economic Evaluation ◽  
Small Cell ◽  
Small Cell Lung

Abstract Backgroud: Evolving practice in non-small cell lung cancer (NSCLC) therapy inevitably impacts health care budgets, especially the introduction of targeted therapies. This results in a rise of health economic evaluations (HEEs) in this domain. The objective of this article is to review the quality of the economic evidence of targeted therapies in metastatic NSCLC. Methods: A literature search using Pubmed, Cochrane, Embase and CRD (University of York Centre for Reviews and Dissemination) database was conducted to identify original articles published between 1/1/2000 and 31/3/2019. A quality of reporting assessment using CHEERS (Consolidated Health Economic Evaluation Reporting Standards statement) was translated into a quantitative score and compared with QHES (Quality of Health Economic Studies) evaluation. Results: Twenty-one HEEs were analyzed. In CHEERS assessment, method description integrity (including setting, perspective, time horizon and discount rate), justification of data sources and heterogeneity description were often absent or incomplete. Only four studies reach the standard of good quality. Modeled articles were mainly evaluated by the QHES instrument, lack of illustrated structure, formula of the transitioning probability and justification for the choice of the model were the most frequent problems in selected studies. After quantification, the CHEERS-scores did not differ significantly from QHES-scores. Conclusion: The overall quality of HEEs in NSCLC targeted therapies is not high. In addition, further efforts are needed to improve the standardization of the model application and the transparency of data description, which is indispensable for valid decision-making on scarce health care resource allocation.

scholarly journals PCV45 Health Economic Evaluation of Ticagrelor in Patients with Acute Coronary Patients (ACS) Based on the Plato Study from A Spanish Health Care Perspective

2011 ◽  
Vol 14 (7) ◽  
pp. A372 ◽  
Author(s):  
L. Delgado-Ortega ◽  
J.L. López-Sendón ◽  
M. Heras Fortuny ◽  
C. Alvarez Sanz ◽  
E. Nikolic ◽  
...  
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Economic Evaluation ◽  
Health Economic Evaluation ◽  
Coronary Patients ◽  
Spanish Health

scholarly journals Sustainability of Community-Based Specialized Mental Health Services in Five European Countries: Protocol for Five Randomized Controlled Trial–Based Health-Economic Evaluations Embedded in the RECOVER-E Program

10.2196/17454 ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. e17454
Author(s):  
Ben F M Wijnen ◽  
Filip Smit ◽  
Ana Ivičević Uhernik ◽  
Ana Istvanovic ◽  
Jovo Dedovic ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Economic ◽  
Economic Evaluation ◽  
Mental Health Services ◽  
Health Services ◽  
Health Economic Evaluation ◽  
Community Based ◽  
Care Costs ◽  
Specialized Mental Health

Background Community-based recovery-oriented mental health services for people with severe mental disorders have not been fully implemented in Bulgaria, Croatia, Macedonia, Montenegro, and Romania. The RECOVER-E project facilitates the implementation of specialized mental health care delivered by setting up services, implementing the services, and evaluating multidisciplinary community mental health teams. The outcomes of the RECOVER-E project are assessed in a trial-based outcome evaluation in each of the participating countries with a health-economic evaluation linked to these trials. Objective The aim of this protocol paper is to describe the methodology that will be used for the health-economic evaluation alongside the trials. Methods Implementation sites have been selected in each of the five countries where hospital-based mental health services are available (care as usual [CAU]) for patients with severe mental disorders (severe depression, bipolar disorder, schizophrenia, and other psychotic disorders). The newly implemented health care system will involve community-based recovery-oriented mental health care (CMHC). At each site, 180 consenting patients will be randomized to either CAU or CMHC. Patient-level outcomes are personal and social functioning and quality-adjusted life years (QALYs). Data on participants’ health care use will be collected and corresponding health care costs will be computed. This enables evaluation of health care costs of CMHC as compared with CAU, and these costs can be related to patient-level outcomes (functioning and QALY gains) in health-economic evaluation. Results Data collection was started in December 2018 (Croatia), February 2019 (Montenegro), April 2019 (Romania), June 2019 (North Macedonia), and October 2019 (Bulgaria). The findings of the outcome evaluations will be reported for each of the five countries separately, and the five trials will be pooled for multilevel analysis on a combined dataset. Conclusions The results of the health-economic evaluation of the RECOVER-E project will contribute to the growing evidence base on the health and economic benefits of recovery-oriented and community-based service models for health systems in transition. Trial Registration (1) ClinicalTrials.gov NCT03922425 (Bulgaria); https://clinicaltrials.gov/ct2/show/NCT03922425 (2) ClinicalTrials.gov NCT03862209 (Croatia); https://clinicaltrials.gov/ct2/show/NCT03862209 (3) ClinicalTrials.gov NCT03892473 (Macedonia); https://clinicaltrials.gov/ct2/show/NCT03892473 (4) ClinicalTrials.gov NCT03837340 (Montenegro); https://clinicaltrials.gov/ct2/show/NCT03837340 (5) ClinicalTrials.gov NCT03884933 (Romania); https://clinicaltrials.gov/ct2/show/NCT03884933 International Registered Report Identifier (IRRID) DERR1-10.2196/17454

2200-PUB: Application of Data Envelopment Analysis in Health Economic Evaluation of Insulin Pump Treatment during Perioperative Period

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2200-PUB
Author(s):  
WEI SONG ◽  
JIANXUAN WEN ◽  
LING ZHAO ◽  
GUANJIE FAN ◽  
MENG LUO ◽  
...  
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
Data Envelopment Analysis ◽  
Insulin Pump ◽  
Health Economic Evaluation ◽  
Perioperative Period ◽  
Data Envelopment
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