Programme of methodological and applied research on economic aspects of perinatal and paediatric health care
Lead Research Organisation:
University of Oxford
Department Name: National Perinatal Epidemiology Unit
Abstract
Strategies to improve the health and broader well-being of pregnant women, mothers and children should necessarily be underpinned by a strong evidence base. Scientific lines of enquiry from a number of disciplines have, to varying degrees, supported evidence-informed policy and practice in perinatal and paediatric health care. Health economics evidence has similarly made an important and relevant contribution to decisions concerning the production, distribution and evaluation of health and health care for pregnant women, mothers and children in the UK. As a relatively new discipline, however, there remain important developments and refinements to be made in several areas of health economic theory and methodology. Moreover, there remain a large number of areas of perinatal and paediatric health care where health economic techniques could usefully contribute to an efficient and equitable allocation of scarce resources. I propose to conduct a programme of methodological and applied research on economic aspects of perinatal and paediatric health care that encompasses: measurement of preference-based outcomes in the perinatal and paediatric contexts; valuation of health gains in the perinatal and paediatric contexts; cost measurement and valuation in the perinatal and paediatric contexts; and the cost-effectiveness of prevention and treatment strategies for preterm birth.
Technical Summary
The discipline of health economics has made an important and relevant contribution to decisions concerning the production, distribution and evaluation of health and health care for pregnant women, mothers and children in the UK. As a relatively new sub-discipline, however, there remain important developments and refinements to be made in several areas of health economic theory and methodology. Moreover, there remain a large number of areas of perinatal and paediatric health care where health economic techniques could usefully contribute to an efficient and equitable allocation of scarce resources.
I propose to conduct a programme of methodological and applied research on economic aspects of perinatal and paediatric health care that encompasses: (1) measurement of preference-based outcomes in the perinatal and paediatric contexts; (2) valuation of health gains in the perinatal and paediatric contexts; (3) cost measurement and valuation in the perinatal and paediatric contexts; and (4) the cost-effectiveness of prevention and treatment strategies for preterm birth. Within the measurement of preference-based outcomes stream, I plan to undertake a number of methodological studies, including a series of studies that will test the empirical validity of multi-attribute utility measures; studies that will establish the degree of concordance between children‘s and parents‘ descriptions and valuations of children‘s health status; studies that will aim to test the validity of the assumptions underlying the quality-adjusted life year (QALY) model in these contexts; and studies that will consider preference elicitation issues within the broader domains of social welfare. Within the valuation of health gains stream, I propose to undertake research that will inform decision-makers about the relative weights attached by members of the general population to a QALY gained by children of various ages and developmental competencies, as well as the weights that are implied from real health care decisions. Within the cost measurement and valuation stream, I plan to extend my previous research on the economic costs of preterm birth, as well as other clinical conditions. Finally, the cost-effectiveness of prevention and treatment strategies for preterm birth stream will synthesise evidence gathered in streams 1-3 within probabilistic decision-analytic models that will aim to estimate the cost-effectiveness of interventions and the expected value of information from future randomised controlled trials in this area. This would have the direct benefit of helping funding bodies, such as the MRC, to set priorities for research in this area.
I propose to conduct a programme of methodological and applied research on economic aspects of perinatal and paediatric health care that encompasses: (1) measurement of preference-based outcomes in the perinatal and paediatric contexts; (2) valuation of health gains in the perinatal and paediatric contexts; (3) cost measurement and valuation in the perinatal and paediatric contexts; and (4) the cost-effectiveness of prevention and treatment strategies for preterm birth. Within the measurement of preference-based outcomes stream, I plan to undertake a number of methodological studies, including a series of studies that will test the empirical validity of multi-attribute utility measures; studies that will establish the degree of concordance between children‘s and parents‘ descriptions and valuations of children‘s health status; studies that will aim to test the validity of the assumptions underlying the quality-adjusted life year (QALY) model in these contexts; and studies that will consider preference elicitation issues within the broader domains of social welfare. Within the valuation of health gains stream, I propose to undertake research that will inform decision-makers about the relative weights attached by members of the general population to a QALY gained by children of various ages and developmental competencies, as well as the weights that are implied from real health care decisions. Within the cost measurement and valuation stream, I plan to extend my previous research on the economic costs of preterm birth, as well as other clinical conditions. Finally, the cost-effectiveness of prevention and treatment strategies for preterm birth stream will synthesise evidence gathered in streams 1-3 within probabilistic decision-analytic models that will aim to estimate the cost-effectiveness of interventions and the expected value of information from future randomised controlled trials in this area. This would have the direct benefit of helping funding bodies, such as the MRC, to set priorities for research in this area.
