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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs: What Broader Non-Health Outcomes Matter Most?

Authors: Tim M. Benning, Adrienne F.G. Alayli-Goebbels, Marie-Jeanne Aarts, Elly Stolk, G. Ardine de Wit, Rilana Prenger, Louise M.A. Braakman-Jansen, Silvia M.A.A. Evers

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Attention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of non-health outcomes in a health promotion context.

Method

We investigated the relative importance of ten non-health outcomes of health promotion programs not commonly captured in QALYs. Preferences were elicited from a sample of the Dutch general public (N = 549) by means of a ranking task. These preferences were analyzed using Borda scores and rank-ordered logit models.

Results

The relative order of preference (from most to least important) was: self-confidence, insights into own (un)healthy behavior, perceived life control, knowledge about a certain health problem, social support, relaxation, better educational achievements, increased labor participation and work productivity, social participation, and a reduction in criminal behavior. The weight given to a particular non-health outcome was affected by the demographic variables age, gender, income, and education. Furthermore, in an open question, respondents mentioned a number of other relevant non-health outcomes, which we classified into outcomes relevant for the individual, the direct social environment, and for society as a whole.

Conclusion

The study provides valuable insights in the non-health outcomes that are considered as most important by the Dutch general population. Ideally, researchers should include the most important non-health outcomes in economic evaluations of health promotion.
Appendix
Available only for authorised users
Footnotes
1
The focus on QALYs may also be a reason why measures of wellbeing that take broader outcomes into account are not used in real-world economic evaluations yet [39].
 
2
Public health interventions have a more diffused focus than clinical interventions and therefore work at different operational levels such as that of the community, population and society [23]. This diffused focus makes it difficult to calculate the cost-effectiveness of public health interventions.
 
3
The development of the Centre for Public Health Excellence followed after publication of the Wanless reports which pointed out that applying economic evaluation methods to multifaceted public health interventions is difficult [42, 43].
 
Literature
1.
2.
Rootman I, Goodstadt M, Potvin L, et al. A framework for health promotion evaluation. In: Rootman I, Goodstadt M, Hyndman B, et al., editors. Evaluation in Health Promotion: Principles and Perspectives. Copenhagen: World Health Organization; 2001.
3.
Smith RD, Petticrew M. Public health evaluation in the twenty-first century: time to see the wood as well as the trees. J Pub Health. 2010;32(1):2–7.CrossRef
4.
Laverack G. Improving health outcomes through community empowerment: a review of the literature. J Health Popul Nutr. 2006;24(1):113–20.PubMed
5.
Zijlstra GA, van Haastregt JC, Ambergen T, et al. Effects of a multicomponent cognitive behavioral group intervention on fear of falling and activity avoidance in community-dwelling older adults: results of a randomized controlled trial. J Am Geriatr Soc. 2009;57(11):2020–8.CrossRefPubMed
6.
Begoray DL, Kwan B. A Canadian exploratory study to define a measure of health literacy. Health Promot Int. 2011;27(1):23–32.CrossRefPubMed
7.
Coast J, Smith RD, Lorgelly P. Welfarism, extra-welfarism and capability: The spread of ideas in health economics. Soc Sci Med. 2008;67:1190–8.CrossRefPubMed
8.
Lorgelly PK, Lawson KD, Fenwick EAL, et al. Outcome Measurement in Economic Evaluations of Public Health Interventions: a Role for the Capability Approach? Int J Environ Res Public Health. 2010;7:2274–89.CrossRefPubMedPubMedCentral
9.
Weatherly H, Drummond M, Claxton K, et al. Methods for assessing the cost-effectiveness of public health interventions: Key challenges and recommendations. Health Policy. 2009;93:85–92.CrossRefPubMed
10.
Prenger R, Braakman-Jansen LM, Pieterse ME, et al. The role of cognition in cost-effectiveness analyses of behavioral interventions. Cost Eff Resour Alloc. 2012;10(3):1–9.
11.
Prenger R, Pieterse ME, Braakman-Jansen LMA, et al. Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions. Eur J Health Econ. 2013;14:297–306.CrossRefPubMed
12.
Goebbels AFG, Lakerveld J, Ament AJHA, et al. Exploring non-health outcomes of health promotion: The perspective of participants in a lifestyle behavior change intervention. Health Policy. 2012;106:177–86.CrossRefPubMed
13.
14.
Van Mastrigt G, Alayli-Goebbels AFG, Aarts M-J, Lawson K, Evers SMAA. Identifying non-health outcomes of health promotion for consideration in economic evaluations from a societal perspective. Submitted
15.
Borghi J, Jan S. Measuring the benefits of health promotion programmes: Application of the contingent valuation method. Health Policy. 2008;87(2):235–48.CrossRefPubMed
16.
Alayli-Goebbels AFG, Dellaert BGC, Knox SA, et al. Consumer Preferences for Health and Nonhealth outcomes of Health Promotion: Results from a Discrete Choice Experiment. Value Health. 2013;16:114–23.CrossRefPubMed
17.
Alayli-Goebbels AFG, Evers SMMA, Alexeeva D, et al. A review of economic evaluations of behavior change interventions: Setting an agenda for research methods and practice. J Pub Health (in press).
18.
Tarn T, Smith M. Pharmacoeconomic guidelines around the world. ISPOR Connections. 2004;10(4):5–12.
19.
Husereau D, Drummond M, Petrou S, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS)—Explanation and Elaboration: A Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value Health. 2013;16(2):231–50.CrossRefPubMed
20.
College voor Zorgverzekeringen. Rapport Richtlijnen voor farmaco-economisch onderzoek, geactualiseerde versie 2006.
21.
Smith MD, Drummond M, Brixner D. Moving the QALY Forward: Rationale for Change. Value Health. 2009;12:S1–4.CrossRef
22.
Drummond M, Sculpher MJ, Torrance GW, et al. Methods for the Economic Evaluation of Health Care Programmes. New York: Oxford University Press; 2005.
23.
Kelly MP, Stewart E, Morgan A, et al. A conceptual framework for public health: NICE’s emerging approach. Public Health. 2009;123(1):e14–20.CrossRefPubMed
24.
Ryan M, Netten A, Skåtun D, et al. Using discrete choice experiments to estimate a preference-based measure of outcome – An application to social care for older people. J Health Econ. 2006;25:927–44.CrossRefPubMed
25.
Benning TM, Kimman ML, Dirksen CD, Boersma LJ, Dellaert BGC. Combining Individual- Level Discrete Choice Experiment Estimates and Costs to Inform Health Care Management Decisions about Customized Care: The Case of Follow-Up Strategies after Breast Cancer Treatment. Value Health. 2012;15(5):680–9.CrossRefPubMed
26.
27.
Kelly MP, Morgan A, Ellis S, Younger T, Huntley J, Swann C. Evidence based public health: A review of the experience of the National Institute of Health and Clinical Excellence (NICE) of developing public health guidance in England. Soc Sci Med. 2010;71:1056–62.CrossRefPubMed
28.
29.
Gudex C, Dolan P, Kind P, et al. Health state valuations from the general public using the Visual Analogue Scale. Qual Life Res. 1996;5:521–31.CrossRefPubMed
30.
Versteegh M, Krabbe P, Evers S, de Wit A, Prenger R, Stolk E. A Dutch tariff for the EQ-5D-5 L. Presented at the30th Euroqol plenary meeting, September 2013, Montreal Canada.
31.
32.
Bech M, Kjaer T, Lauridsen J. Does the number of choice sets matter? Results from a web survey applying a discrete choice experiment. Health Econ. 2011;20(3):273–86.CrossRefPubMed
33.
Fishburn PC, Gehrlein WV. Borda’s rule, positional voting, and Condorcet’s simple majority principle. Public Choice. 1976;28:79–88.CrossRef
34.
35.
Dolan P, Tsuchiya A. Health priorities and public preferences: the relative importance of past health experience and future health prospects. J Health Econ. 2005;24:703–14.CrossRefPubMed
36.
37.
Graham C. Happiness and health: Lessons – and questions – for public policy. Health Aff. 2008;27(1):72–87.CrossRef
38.
Witt J, Scott A, Osborne RH. Designing choice experiments with many attributes. An application to setting priorities to orthopaedic waiting lists. Health Econ. 2009;18:681–96.CrossRefPubMed
39.
Al-Janabi H, Flynn TN, Coast J, et al. Development of a self-report measure of capability wellbeing for adults: the ICECAP-A. Qual Life Res. 2012;21:167–76.CrossRefPubMed
40.
Prenger R, Pieterse ME, Braakman-Jansen LMA, et al. Dealing with missing behavioral endpoints in health promotion research by modeling cognitive parameters in cost-effectiveness analyses of behavioral interventions: A validation study. Health Econ. 2014. doi:10.​1002/​hec.​3119.PubMed
41.
Connely LB. Economics and health promotion. Eur J Health Econ. 2004;5:236–42.CrossRef
42.
Wanless D. Securing Our Future Health: Taking a Long-Term View. Final Report. London: HM Treasury; 2002.
43.
Wanless D. Securing Good Health for the Whole Population. Final Report. London: HM Treasury; 2004.
Metadata
Title
Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs: What Broader Non-Health Outcomes Matter Most?
Authors
Tim M. Benning
Adrienne F.G. Alayli-Goebbels
Marie-Jeanne Aarts
Elly Stolk
G. Ardine de Wit
Rilana Prenger
Louise M.A. Braakman-Jansen
Silvia M.A.A. Evers
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0908-y

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