Measuring and valuing the broader patient benefits from health and care in economic evaluations

在经济评估中衡量和评估患者从健康和护理中获得的更广泛的利益

• 批准号: 2833751
• 金额: --
• 依托单位: University of Bristol
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2833751
• 关键词: Measuring; valuing; broader; patient; benefits

BackgroundSince the establishment of the National Institute of Health and Care Excellence (NICE) in 1999 as an independent body to the Department of Health, the role of economic analysis in deciding how best to spend the £120 billion taxpayer funds provided to the NHS annually has increased substantially. NICE recommends a standard approach for economic analysis of healthcare treatments, allowing decisions on value for money to be made consistently across different patient populations and treatment types. To do this, NICE recommends that measures of patient quality of life benefit focus on health gain from treatment, using the EQ-5D questionnaire; patients self-report their current problems across five health areas (1. walking about, 2. washing and dressing, 3. usual activities, 4. pain or discomfort, 5. anxiety or depression).There is growing interest in trying to also measure the broader quality of life benefits of healthcare treatments beyond patient health gains to also include gains in patient wellbeing. One way of measuring patient wellbeing in economic analysis is to focus on individual capability, that is, the freedom to achieve the aspects of life that are important to you, such as being independent and having enjoyment and pleasure. Questionnaires measuring capability have been developed, such as the ICECAP questionnaire for adults. This asks about a person's capability to achieve in five areas of life (1. feeling settled and secure, 2. love, friendship and support, 3. being independent, 4. achievement and progress, 5. enjoyment and pleasure). NICE and the Dutch equivalent of NICE now recommend using capability questionnaires in certain contexts, such as social care and long-term conditions. However, there is no guidance as to how this information on capability can be combined with existing health outcomes to inform value for money decision-making. This is important as not consistently including information on capability could mean that treatments offering patients broader benefits to quality of life than their health alone will not be routinely provided by the NHS.The aim of this research is to simultaneously include information on health and capability quality of life benefits that patients report from the treatments they receive, so that this information can be used to aid national healthcare decision-making. This research will allow for broader patient quality of life benefits to be consistently included in the economic analysis of healthcare treatments. This could have important implications in terms of the treatments that are considered to provide the most patient benefit from scarce healthcare resources, and thus that the NHS funds.Research for this PhD will include:1. A systematic review of the methods available to include multiple outcomes in economic evaluations of health and care interventions;2. Conceptualising an economic evaluation framework that is consistent with the capability approach and health economics principles;3. A valuation study including EQ-5D-5L and ICECAP-A, to demonstrate the practical application of the framework developed in (2).

自1999年国家健康与护理卓越研究所（NICE）作为卫生部的独立机构成立以来，经济分析在决定如何最好地使用每年向NHS提供的1200亿英镑纳税人资金方面的作用大幅增加。NICE推荐了一种标准的医疗保健治疗经济分析方法，允许在不同的患者人群和治疗类型中一致地做出物有所值的决定。为了做到这一点，NICE建议，患者生活质量受益的衡量标准应使用EQ-5D问卷，重点关注治疗带来的健康益处;患者自我报告他们在五个健康领域（1.行走，2。洗衣服，3。日常活动4。疼痛或不适，5。越来越多的兴趣在于尝试还测量除了患者健康增益之外的健康护理治疗的更广泛的生活质量益处，以还包括患者健康的增益。在经济分析中，衡量患者幸福感的一种方法是关注个人能力，即实现对你来说重要的生活方面的自由，例如独立和享受。已经制定了衡量能力的标准，如ICECAP成人问卷。这是关于一个人在生活的五个方面实现的能力（1。有安全感和安全感，2。爱、友谊和支持; 3.独立，4。成就与进步，5。享受和快乐）。NICE和荷兰的NICE现在建议在某些情况下使用能力问卷，例如社会护理和长期条件。然而，没有指导说明如何将这一能力信息与现有保健成果结合起来，为资金效益决策提供信息。这一点很重要，因为不一致地包括有关能力的信息可能意味着NHS不会常规提供为患者提供比其健康更广泛的生活质量益处的治疗。本研究的目的是同时包括患者报告的来自其接受的治疗的健康和能力生活质量益处的信息，这样这些信息就可以用来帮助国家的医疗保健决策。这项研究将使更广泛的患者生活质量受益始终纳入医疗保健治疗的经济分析中。这可能有重要的影响，在治疗方面，被认为是提供最多的病人受益于稀缺的医疗资源，因此，NHS的资金。对可用于在卫生和保健干预措施的经济评估中包括多种结果的方法进行系统性审查;2.概念化的经济评价框架，是符合能力的方法和卫生经济学原则;3。评估研究，包括EQ-5D-5L和ICECAP-A，以证明（2）中开发的框架的实际应用。