Evaluation of housing adaptation interventions: integrating the economic perspective into occupational therapy practice
Evaluation of housing adaptation interventions: integrating the economic perspective into occupational therapy practice
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DOI：
10.3109/11038128.2014.900109
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发表时间：
2014-09-01
影响因子：
1.9
通讯作者：
Iwarsson, Susanne
中科院分区：
文献类型：
--
作者：
Chiatti, Carlos;Iwarsson, Susanne
目标：家庭环境是健康、生活质量和幸福的关键决定因素。鉴于其与这些方面的相关性，旨在消除残疾人家庭中的环境障碍和无障碍问题的住房适应（HA）干预措施的评估的缺乏令人惊讶。本文旨在通过促进卫生经济学中使用的有效性、成本和成本效益概念的传播和应用，为制定 HA 干预措施的经济评估策略做出贡献。方法：重点仅限于评估 HA 干预措施的三个总体问题。考虑到 X 和 Y 是针对同一个案的两种假设干预措施，本文提出以下问题：(i) X 会比 Y 更有效吗？ (ii) X 的成本会比 Y 更高吗？ (iii) X 会比 Y 更具成本效益吗？对虚构案例的小插图式描述用于举例说明文章中解释的经济概念。结果和结论：在结论中，强调需要有关 HA 干预措施的成本和结果的新实验数据，以便实现合理的评估，并有可能为该领域的政策和专业人员提供信息。鉴于各国情况的异质性，以一致的方式应用系统方法可以加强跨国研究和合作。
Objective: The home environment is a key determinant of health, quality of life, and well-being. Given its relevance for such aspects, the scarcity of evaluations of housing adaptation (HA) interventions aimed at removing environmental barriers and accessibility problems in the homes of people with disabilities is surprising. This article aims to contribute to the development of strategies for economic evaluations of HA interventions, by stimulating the dissemination and application of the concepts of effectiveness, cost, and cost-effectiveness as used within health economics. Methods: The focus is limited to three overarching questions for the evaluation of HA interventions. Considering X and Y as two hypothetical interventions for the same individual case, the article asks: (i) Will X be more effective than Y?; (ii) Will X cost more than Y?, and (iii) Will X be more cost-effective than Y? Vignette-like descriptions of fictional cases are used to exemplify the economic concepts explained in the article. Results and conclusion: In the conclusion, the need is stressed for new experimental data regarding both costs and outcomes of HA interventions, in order to realize sound evaluations with the potential to inform policy and professionals in this field. Given the heterogeneity among national contexts, systematic approaches applied in a coherent manner could strengthen cross-national research and collaborations.