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

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Cost-Benefit Analysis* ; Expert Testimony* ; Outcome Assessment, Health Care*; Public Health/*economics; Humans ; Interviews as Topic ; Netherlands ; Surveys and Questionnaires

Background: Public health interventions can impact a broad number of outcomes, including both health and non-health outcomes (NHOs). However, although it is often acknowledged that it's important to take NHOs into account in economic evaluation studies, in practice these are often neglected. To address this issue, our study investigated expert views regarding the incorporation of NHOs into the economic evaluations of public health interventions, by means of a qualitative study.
Methods: A purposive sampling method was used to recruit the experts in the field of health economics and/or public health for this study. Twenty-two semi-structured interviews were held. After recording, the interviews were transcribed verbatim and entered in Nvivo. The data was analyzed using a thematic analysis to identify all important themes mentioned by the experts. Data collection and analysis was continued until saturation was reached. Multiple coding and validity checks were performed to further strengthen the rigour of our methodology.
Results: Based on the expert interviews, the following overarching themes were identified; Theme 1: NHOs on the individual level, direct social level and societal level. Theme 2: Pros and Cons regarding the development of a new instrument to measure NHOs. Theme 3: The most important requirements for a new questionnaire to be developed for measuring broader outcomes. Theme 4: Alternative methods which could be used for measuring and valuating NHOs in economic evaluations for public health.
Discussion: Our research findings indicate that the importance of NHOs and the need to measure them are universally accepted. Most of the experts acknowledge the importance of measuring broader outcomes and support the development of a new instrument to measure these. The experts, who do not support the development of a new instrument, question its usefulness and feasibility; i.e., they are not sure whether it is possible to valuate NHOs. Furthermore, experts have strong and sometimes conflicting views on the specific requirements of a new instrument to be developed for measuring NHOs. They did not identify a single preferred alternative method for measurement and valuation.
Conclusions: Most experts find a wide range of NHOs important and are in favor of developing a new instrument for identifying and measuring NHOs. Hence, an open discussion needs to be initiated with experts and other stakeholders about which steps need to be taken to move forward.

Health Econ Policy Law. 2009 Apr;4(Pt 2):231-45. (PMID: 19216834)
Health Econ. 2009 Mar;18(3):321-36. (PMID: 18651601)
J Public Health (Oxf). 2010 Mar;32(1):2-7. (PMID: 20181759)
Int J Environ Res Public Health. 2010 May;7(5):2274-89. (PMID: 20623024)
Soc Sci Med. 2010 Sep;71(6):1056-62. (PMID: 20678836)
Qual Life Res. 2010 Oct;19(8):1087-96. (PMID: 20512662)
Am J Pharm Educ. 2010 Oct 11;74(8):141. (PMID: 21179252)
Health Policy. 2011 Jun;101(1):11-9. (PMID: 21030107)
Value Health. 2012 Dec;15(8):1172-81. (PMID: 23244821)
Value Health. 2012 Sep-Oct;15(6):796-803. (PMID: 22999128)
Pharmacoeconomics. 2011 Aug;29(8):641-52. (PMID: 21604821)
Qual Life Res. 2013 Sep;22(7):1831-40. (PMID: 23086535)
J Epidemiol Community Health. 2013 Oct;67(10):829-34. (PMID: 23868529)
J Ment Health Policy Econ. 2013 Dec;16(4):179-86. (PMID: 24526586)
J Public Health (Oxf). 2014 Jun;36(2):336-44. (PMID: 23965640)
Int J Qual Stud Health Well-being. 2014;9:26152. (PMID: 25326092)
BMC Public Health. 2015;15:582. (PMID: 26099274)
BMC Health Serv Res. 2015;15:266. (PMID: 26169779)
Annu Rev Psychol. 2001;52:141-66. (PMID: 11148302)
Health Econ. 2001 Jan;10(1):39-52. (PMID: 11180568)
Pharmacoeconomics. 2004;22(11):691-700. (PMID: 15250748)
Am Psychol. 1976 Feb;31(2):117-24. (PMID: 1267244)
BMJ. 1995 Jul 8;311(6997):109-12. (PMID: 7613363)
Health Econ. 1996 May-Jun;5(3):241-7. (PMID: 8817298)
Health Econ. 2008 Mar;17(3):441-8. (PMID: 17764094)
Health Econ. 2008 Jun;17(6):667-70. (PMID: 18457341)
BMJ. 2008 Jun 7;336(7656):1281-3. (PMID: 18535071)
Health Policy. 2008 Aug;87(2):235-48. (PMID: 18295926)
Soc Sci Med. 2008 Oct;67(7):1190-8. (PMID: 18657346)
Qual Life Res. 2008 Sep;17(7):967-76. (PMID: 18622721)
Public Health. 2009 Jan;123(1):e14-20. (PMID: 19100588)
Health Policy. 2009 Dec;93(2-3):85-92. (PMID: 19709773)

Date Created: 20150925 Date Completed: 20160415 Latest Revision: 20191210

20231215

PMC4581076

10.1186/s12889-015-2247-7

26399520