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  1. Article ; Online: Methods for think-aloud interviews in health-related resource-use research: the PECUNIA RUM instrument.

    Janssen, L M M / Pokhilenko, I / Drost, R M W A / Paulus, A T G / Thorn, J / Hollingworth, W / Noble, S / Berger, M / Simon, J / Evers, S M A A

    Expert review of pharmacoeconomics & outcomes research

    2023  Volume 23, Issue 4, Page(s) 383–389

    Abstract: Background: The think-aloud (TA) approach is a qualitative research method that allows for gaining insight into thoughts and cognitive processes. It can be used to incorporate a respondent's perspective when developing resource-use measurement (RUM) ... ...

    Abstract Background: The think-aloud (TA) approach is a qualitative research method that allows for gaining insight into thoughts and cognitive processes. It can be used to incorporate a respondent's perspective when developing resource-use measurement (RUM) instruments. Currently, the application of TA methods in RUM research is limited, and so is the guidance on how to use them. Transparent publication of TA methods for RUM in health economics studies, which is the aim of this paper, can contribute to reducing the aforementioned gap.
    Methods: Methods for conducting TA interviews were iteratively developed by a multi-national working group of health economists and additional qualitative research expertise was sought. TA interviews were conducted in four countries to support this process. A ten-step process was outlined in three parts: Part A 'before the interview' (including translation, recruitment, training), Part B 'during the interview' (including setting, opening, completing the instrument, open-ended questions, closing), and part C 'after the interview' (including transcription and data analysis, trustworthiness).
    Conclusions: This manuscript describes the step-by-step approach for conducting multi-national TA interviews with potential respondents of the PECUNIA RUM instrument. It increases the methodological transparency in RUM development and reduces the knowledge gap of using qualitative research methods in health economics.
    MeSH term(s) Humans ; Surveys and Questionnaires ; Research Design
    Language English
    Publishing date 2023-03-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2208481-2
    ISSN 1744-8379 ; 1473-7167
    ISSN (online) 1744-8379
    ISSN 1473-7167
    DOI 10.1080/14737167.2023.2187379
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  2. Article ; Online: Using Economics to Impact Local Obesity Policy: Introducing the UK Centre for Economics of Obesity (CEO).

    Frew, Emma / Afentou, Nafsika / Mohtashami Borzadaran, Hamideh / Candio, Paolo / Pokhilenko, Irina

    Applied health economics and health policy

    2022  Volume 20, Issue 5, Page(s) 629–635

    Abstract: Worldwide, population obesity levels are at their highest recorded levels, having nearly tripled between 1975 and 2016. This leads to substantial pressure on health systems, a negative impact on economic development, and results in adverse physical and ... ...

    Abstract Worldwide, population obesity levels are at their highest recorded levels, having nearly tripled between 1975 and 2016. This leads to substantial pressure on health systems, a negative impact on economic development, and results in adverse physical and mental health outcomes. There are many economic reasons why reducing population obesity should be a priority, and global targets have been set with many governments pledging to reduce obesity levels by 2030. To achieve these targets, a 'system-wide' approach has been widely advocated in direct recognition of the wide-ranging complex interacting determinants of the disease. This system approach requires action at all levels, including at the local government level, to use all fiscal and non-fiscal levers to bring about local system change that promotes healthier population behaviours. Like many country contexts, in England, local resources for achieving this system change have been drastically reduced in recent years. Economic evaluation offers a formal explicit framework to support local decision making but, to date, there has been a disconnect between national guidance on cost-effectiveness and how that informs local action. A new Centre for Economics of Obesity has been purposively developed to work closely with local government to adapt methods to help achieve efficiency and equity gains. By working across six workstreams to begin with, this Centre will use economics to inform policy action on different but interrelated parts of the obesity system and act as a training hub for health economists working in obesity policy.
    MeSH term(s) Cost-Benefit Analysis ; Health Policy ; Humans ; Local Government ; Obesity/prevention & control ; United Kingdom
    Language English
    Publishing date 2022-06-20
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2171420-4
    ISSN 1179-1896 ; 1175-5652
    ISSN (online) 1179-1896
    ISSN 1175-5652
    DOI 10.1007/s40258-022-00738-9
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  3. Article ; Online: Relationship between trust and patient involvement in medical decision-making: A cross-sectional study.

    Pokhilenko, Irina / van Esch, Thamar E M / Brabers, Anne E M / de Jong, Judith D

    PloS one

    2021  Volume 16, Issue 8, Page(s) e0256698

    Abstract: Introduction: Patients vary in their preferences regarding involvement in medical decision-making. Current research does not provide complete explanation for this observed variation. Patient involvement in medical decision-making has been found to be ... ...

    Abstract Introduction: Patients vary in their preferences regarding involvement in medical decision-making. Current research does not provide complete explanation for this observed variation. Patient involvement in medical decision-making has been found to be influenced by various mechanisms, one of which could be patients' trust in physicians. The aim of this study was to examine whether trust in physicians fosters or impairs patient involvement in medical decision-making. This study also aimed to determine to what extent the relationship between trust and preferences regarding decision-making roles was influenced by the sociodemographic characteristics of the patients. We hypothesised that trust can both foster and impair patient involvement in medical decision-making.
    Materials and methods: A survey was sent out to members of the Nivel Dutch Health Care Consumer Panel in February 2016 (response rate = 47%, N = 703). The Wake Forest Physician Trust Scale was used to measure trust. Patient involvement was measured using two items based on the study published by Flynn and colleagues in 2006. Multiple regression analysis was used to analyse the relationship between trust and patient involvement.
    Results: We found a negative relationship between trust and patient involvement in medical decision-making in men. Women with high trust reported to be more involved in medical decision-making compared to men with high trust.
    Conclusion: The results suggest that trust impairs involvement in medical decision-making for men but not for women. Further research could provide a more comprehensive explanation of the variation in patient preferences regarding involvement in medical decision-making to further elucidate which underlying mechanisms could enhance patient participation.
    MeSH term(s) Clinical Decision-Making ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Physician-Patient Relations ; Physicians ; Regression Analysis ; Trust
    Language English
    Publishing date 2021-08-26
    Publishing country United States
    Document type Journal Article
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0256698
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  4. Article ; Online: International comparability of reference unit costs of education services: when harmonizing methodology is not enough (PECUNIA project).

    Pokhilenko, I / Kast, T / Janssen, L M M / Evers, S M A A / Paulus, A T G / Simon, J / Mayer, S / Berger, M / Konnopka, A / Muntendorf, L / Brodszky, V / García-Pérez, L / Park, A / Salvador-Carulla, L / Drost, R M W A

    Expert review of pharmacoeconomics & outcomes research

    2022  

    Abstract: Background: Health problems can lead to costs in the education sector. However, these costs are rarely incorporated in health economic evaluations due to the lack of reference unit costs (RUCs), cost per unit of service, of education services and of ... ...

    Abstract Background: Health problems can lead to costs in the education sector. However, these costs are rarely incorporated in health economic evaluations due to the lack of reference unit costs (RUCs), cost per unit of service, of education services and of validated methods to obtain them. In this study, a standardized unit cost calculation tool developed in PECUNIA project, the PECUNIA RUC Template for services, was applied to calculate the RUCs of selected education services in five European countries.
    Methods: The RUCs of special education services and of educational therapy were calculated using the information collected via an exploratory grey literature search and contact with service providers.
    Results: The RUCs of special education services ranged from €55 to €189 per school day. The RUCs of educational therapy ranged from €6 to €25 per contact and from €5 to €35 per day. Variation was observed in the type of input data and measurement unit, among other.
    Discussion: The tool helped reduce variability in the RUCs related to costing methodology and gain insights into other aspects that contribute to the variability (e.g. data availability). Further research and efforts to generate high quality input data are required to reduce the variability of the RUCs.
    Language English
    Publishing date 2022-12-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2208481-2
    ISSN 1744-8379 ; 1473-7167
    ISSN (online) 1744-8379
    ISSN 1473-7167
    DOI 10.1080/14737167.2023.2152331
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  5. Article ; Online: Do Costs in the Education Sector Matter? A Systematic Literature Review of the Economic Impact of Psychosocial Problems on the Education Sector.

    Pokhilenko, Irina / Janssen, Luca M M / Evers, Silvia M A A / Drost, Ruben M W A / Schnitzler, Lena / Paulus, Aggie T G

    PharmacoEconomics

    2021  Volume 39, Issue 8, Page(s) 889–900

    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, ... ...

    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.
    MeSH term(s) Adolescent ; Child ; Cost-Benefit Analysis ; Educational Status ; Humans
    Language English
    Publishing date 2021-06-14
    Publishing country New Zealand
    Document type Research Support, Non-U.S. Gov't ; Systematic Review
    ZDB-ID 1100273-6
    ISSN 1179-2027 ; 1170-7690
    ISSN (online) 1179-2027
    ISSN 1170-7690
    DOI 10.1007/s40273-021-01049-y
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  6. Article ; Online: The broader societal impacts of COVID-19 and the growing importance of capturing these in health economic analyses.

    Schnitzler, Lena / Janssen, Luca M M / Evers, Silvia M A A / Jackson, Louise J / Paulus, Aggie T G / Roberts, Tracy E / Pokhilenko, Irina

    International journal of technology assessment in health care

    2021  Volume 37, Page(s) e43

    Abstract: AbstractThe rapid spread of the current COVID-19 pandemic has affected societies worldwide, leading to excess mortality, long-lasting health consequences, strained healthcare systems, and additional strains and spillover effects on other sectors outside ... ...

    Abstract AbstractThe rapid spread of the current COVID-19 pandemic has affected societies worldwide, leading to excess mortality, long-lasting health consequences, strained healthcare systems, and additional strains and spillover effects on other sectors outside health (i.e., intersectoral costs and benefits). In this perspective piece, we demonstrate the broader societal impacts of COVID-19 on other sectors outside the health sector and the growing importance of capturing these in health economic analyses. These broader impacts include, for instance, the effects on the labor market and productivity, education, criminal justice, housing, consumption, and environment. The current pandemic highlights the importance of adopting a societal perspective to consider these broader impacts of public health issues and interventions and only omit these where it can be clearly justified as appropriate to do so. Furthermore, we explain how the COVID-19 pandemic exposed and exacerbated existing deep-rooted structural inequalities that contribute to the wider societal impacts of the pandemic.
    MeSH term(s) COVID-19/economics ; COVID-19/epidemiology ; Cost of Illness ; Costs and Cost Analysis ; Economics, Medical/organization & administration ; Education/economics ; Efficiency ; Humans ; Models, Economic ; Pandemics ; SARS-CoV-2 ; Workforce/economics
    Language English
    Publishing date 2021-03-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 632573-7
    ISSN 1471-6348 ; 0266-4623
    ISSN (online) 1471-6348
    ISSN 0266-4623
    DOI 10.1017/S0266462321000155
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  7. Article ; Online: Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM.

    Pokhilenko, Irina / Janssen, Luca M M / Paulus, Aggie T G / Drost, Ruben M W A / Hollingworth, William / Thorn, Joanna C / Noble, Sian / Simon, Judit / Fischer, Claudia / Mayer, Susanne / Salvador-Carulla, Luis / Konnopka, Alexander / Hakkaart van Roijen, Leona / Brodszky, Valentin / Park, A-La / Evers, Silvia M A A

    Applied health economics and health policy

    2023  Volume 21, Issue 2, Page(s) 155–166

    Abstract: Background: Measuring objective resource-use quantities is important for generating valid cost estimates in economic evaluations. In the absence of acknowledged guidelines, measurement methods are often chosen based on practicality rather than ... ...

    Abstract Background: Measuring objective resource-use quantities is important for generating valid cost estimates in economic evaluations. In the absence of acknowledged guidelines, measurement methods are often chosen based on practicality rather than methodological evidence. Furthermore, few resource-use measurement (RUM) instruments focus on the measurement of resource use in multiple societal sectors and their development process is rarely described. Thorn and colleagues proposed a stepwise approach to the development of RUM instruments, which has been used for developing cost questionnaires for specific trials. However, it remains unclear how this approach can be translated into practice and whether it is applicable to the development of generic self-reported RUM instruments and instruments measuring resource use in multiple sectors. This study provides a detailed description of the practical application of this stepwise approach to the development of a multi-sectoral RUM instrument developed within the ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) project.
    Methods: For the development of the PECUNIA RUM, the methodological approach was based on best practice guidelines. The process included six steps, including the definition of the instrument attributes, identification of cost-driving elements in each sector, review of methodological literature and development of a harmonized cross-sectorial approach, development of questionnaire modules and their subsequent harmonization.
    Results: The selected development approach was, overall, applicable to the development of the PECUNIA RUM. However, due to the complexity of the development of a multi-sectoral RUM instrument, additional steps such as establishing a uniform methodological basis, harmonization of questionnaire modules and involvement of a broader range of stakeholders (healthcare professionals, sector-specific experts, health economists) were needed.
    Conclusion: This is the first study that transparently describes the development process of a generic multi-sectoral RUM instrument in health economics and provides insights into the methodological aspects and overall validity of its development process.
    MeSH term(s) Humans ; Europe ; Surveys and Questionnaires ; Cost-Benefit Analysis ; Health Personnel
    Language English
    Publishing date 2023-01-09
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2171420-4
    ISSN 1179-1896 ; 1175-5652
    ISSN (online) 1179-1896
    ISSN 1175-5652
    DOI 10.1007/s40258-022-00780-7
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  8. Article ; Online: The Relative Importance of Education and Criminal Justice Costs and Benefits in Economic Evaluations: A Best-Worst Scaling Experiment.

    Pokhilenko, Irina / Janssen, Luca M M / Hiligsmann, Mickael / Evers, Silvia M A A / Drost, Ruben M W A / Paulus, Aggie T G / Bremmers, Leonarda G M

    PharmacoEconomics

    2020  Volume 39, Issue 1, Page(s) 99–108

    Abstract: Objectives: Mental and behavioural disorders (MBDs) and interventions targeting MBDs lead to costs and cost savings in the healthcare sector, but also in other sectors. The latter are referred to as intersectoral costs and benefits (ICBs). Interventions ...

    Abstract Objectives: Mental and behavioural disorders (MBDs) and interventions targeting MBDs lead to costs and cost savings in the healthcare sector, but also in other sectors. The latter are referred to as intersectoral costs and benefits (ICBs). Interventions targeting MBDs often lead to ICBs in the education and criminal justice sectors, yet these are rarely included in economic evaluations. This study aimed to investigate the attitudes held by health economists and health technology assessment experts towards education and criminal justice ICBs in economic evaluations and to quantify the relative importance of these ICBs in the context of MBDs.
    Methods: An online survey containing open-ended questions and two best-worst scaling object case studies was conducted in order to prioritise a list of 20 education ICBs and 20 criminal justice ICBs. Mean relative importance scores for each ICB were generated using hierarchical Bayes analysis.
    Results: Thirty-nine experts completed the survey. The majority of the respondents (68%) reported that ICBs were relevant, but only a few (32%) included them in economic evaluations. The most important education ICBs were "special education school attendance", "absenteeism from school", and "reduced school attainment". The most important criminal justice ICBs were "decreased chance of committing a crime as a consequence/effect of mental health programmes/interventions", "jail and prison expenditures", and "long-term pain and suffering of victims/victimisation".
    Conclusions: This study identified the most important education and criminal justice ICBs for economic evaluations of interventions targeting MBDs and suggests that it could be relevant to include these ICBs in economic evaluations.
    MeSH term(s) Bayes Theorem ; Cost-Benefit Analysis/methods ; Criminal Law ; Health Services ; Humans ; Mental Disorders
    Language English
    Publishing date 2020-10-07
    Publishing country New Zealand
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1100273-6
    ISSN 1179-2027 ; 1170-7690
    ISSN (online) 1179-2027
    ISSN 1170-7690
    DOI 10.1007/s40273-020-00966-8
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  9. Article: Intersectoral Costs and Benefits of Mental and Behavioural Disorders in the Education Sector: an Exploration of Costing Methods.

    Bremmers, Leonarda G M / Evers, Silvia M A A / Drost, Ruben M W A / Janssen, Luca M M / Pokhilenko, Irina / Paulus, Aggie T G / Norton, Edward C / Yoon, Jangho / Cuddeback, Gary S / Morrissey, Joseph P

    The journal of mental health policy and economics

    2021  Volume 23, Issue 3, Page(s) 115–137

    Abstract: Background: The inclusion of indirect spillover costs and benefits that occur in non-healthcare sectors of society is necessary to make optimal societal decisions when assessing the cost effectiveness of healthcare interventions. Education costs and ... ...

    Abstract Background: The inclusion of indirect spillover costs and benefits that occur in non-healthcare sectors of society is necessary to make optimal societal decisions when assessing the cost effectiveness of healthcare interventions. Education costs and benefits are relevant in the disease area of mental and behavioral disorders, but their inclusion in economic evaluations is largely neglected due to lack of methodological knowledge.
    Aim of the study: This study aims to explore, using a scoping review, the identification, measurement, and valuation methods used to assess the impact of mental and behavioural disorders on education costs and benefits.
    Methods: A scoping review was conducted to identify articles that were set in the education sector and assessed education costs and benefits. An adapted 5-step approach was used: (i) initating a scoping review; (ii) identifying component studies; (iii) data extraction; (iv) reporting results; (v) discussion and interpretation of findings. Results were summarized in a narrative synthesis per identification, measurement, and valuation method.
    Results: 177 component articles were identified in the scoping review that reported 61 mutually exclusive education costs and benefits. The nomenclature used to describe the costs and benefits was poorly defined, heterogeneous in nature and largely context dependent. This was also reflected in the diverse number of measurement and valuation methods found in the component articles.
    Discussion: This is the first study, which offers a classification of education costs and benefits and costing methods reported by studies set in the education sector. In conclusion, mental and behavioral disorders have a notable impact on a variety of different education costs and benefits.
    Implications for health policies: The classification provided in the current study gives an indication of the wide-spread impact of mental and behavioral disorders on the education sector. Hence, the inclusion of relevant education costs and benefits in economic evaluations for mental and behavioral disorders is necessary to make optimal societal decisions.
    Implications for further research: By exploring a new area of research from a sector-specific perspective, the current study adds to the existing intersectoral cost and benefit literature base. Future research should focus on standardizing costing methods in pharmacoeconomic guidelines and assessing the relative importance of individual education costs and benefits in economic evaluations for specific interventions and diseases.
    MeSH term(s) Cost-Benefit Analysis ; Delivery of Health Care/statistics & numerical data ; Health Care Costs/statistics & numerical data ; Health Services/statistics & numerical data ; Humans ; Mental Disorders/psychology ; Mental Disorders/therapy ; Problem Behavior
    Language English
    Publishing date 2021-01-07
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 1401618-7
    ISSN 1091-4358
    ISSN 1091-4358
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Aspects and Challenges of Resource Use Measurement in Health Economics: Towards a Comprehensive Measurement Framework.

    Janssen, Luca M M / Drost, Ruben M W A / Paulus, Aggie T G / Garfield, Kirsty / Hollingworth, William / Noble, Sian / Thorn, Joanna C / Pokhilenko, Irina / Evers, Silvia M A A

    PharmacoEconomics

    2021  Volume 39, Issue 9, Page(s) 983–993

    Abstract: Background: While the methods for conducting health economics research in general are improving, current guidelines provide limited guidance regarding resource use measurement (RUM). Consequently, a variety of methods exists, yet there is no overview of ...

    Abstract Background: While the methods for conducting health economics research in general are improving, current guidelines provide limited guidance regarding resource use measurement (RUM). Consequently, a variety of methods exists, yet there is no overview of aspects to consider when deciding on the most appropriate RUM methodology. Therefore, this study aims to (1) identify and categorize existing knowledge regarding aspects of RUM, and (2) develop a framework that provides a comprehensive overview of methodological aspects regarding RUM.
    Methods: Relevant articles were identified by enrolling a search string in six databases and handsearching the DIRUM database. Included articles were descriptively reviewed and served as input for a comprehensive framework. Health economics experts were involved during the process to establish the framework's face validity.
    Results: Forty articles were included in the scoping review. The RUM framework consists of four methodological RUM domains: 'Whom to measure', addressing whom to ask and whom to measure; 'How to measure', addressing the different approaches of measurement; 'How often to measure', addressing recall period and measurement patterns; and 'Additional considerations', which covers additional aspects that are essential for further refining the methodologies for measurement. Evidence retrieved from the scoping review was categorized according to these domains.
    Conclusion: This study clustered the aspects of RUM methodology in health economics into a comprehensive framework. The results may guide health economists in their decision making regarding the selection of appropriate RUM methods and developing instruments for RUM. Furthermore, policy makers may use these findings to review study results from an evidence-based perspective.
    MeSH term(s) Databases, Factual ; Economics, Medical ; Humans ; Reproducibility of Results
    Language English
    Publishing date 2021-06-25
    Publishing country New Zealand
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1100273-6
    ISSN 1179-2027 ; 1170-7690
    ISSN (online) 1179-2027
    ISSN 1170-7690
    DOI 10.1007/s40273-021-01048-z
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    ab Jg. 2022: Lesesaal (EG)

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