European Journal of Health Economics最新文献

{"title":"Psychometric benefits of adding bolt-ons to the EQ-5D-5L in populations undergoing minimally invasive cosmetic procedures.","authors":"Eszter Mercédesz Müller, Anna Nikl, Máté Krebs, Péter Holló, Valentin Brodszky, Lajos Vince Kemény, Fanni Rencz","doi":"10.1007/s10198-025-01772-9","DOIUrl":"10.1007/s10198-025-01772-9","url":null,"abstract":"<p><strong>Objectives: </strong>There is growing interest in measuring health outcomes associated with minimally invasive cosmetic procedures (MICPs), such as botulinum toxin and hyaluronic acid injections. However, the EQ-5D may have limited content validity for this purpose. This study aims to psychometrically test five additional dimensions ('bolt-ons') for the EQ-5D-5L in individuals planning or undergoing MICPs.</p><p><strong>Methods: </strong>In 2023, a cross-sectional, online survey was conducted with 149 women planning MICPs and 215 who had recently undergone them. Respondents completed the EQ-5D-5L, five bolt-ons (skin irritation, self-confidence, sleep, social relationships, tiredness), the Rosenberg Self-Esteem Scale (RSES) and the Brief Fear of Negative Evaluation Scale-Straightforward Items (BFNE-S). The following psychometric properties were tested for the EQ-5D-5L + bolt-on(s): ceiling, convergent and divergent validity, explanatory power and known-groups validity.</p><p><strong>Results: </strong>Adding tiredness (22%), self-confidence (23%) or sleep bolt-ons (27%) substantially reduced the ceiling of the EQ-5D-5L (47%). The self-confidence and social relationships bolt-ons showed a moderate or strong correlation with the RSES and BFNE-S total scores (-0.462 to -0.679). The tiredness and self-confidence bolt-ons improved the EQ-5D-5L's explained variance in EQ VAS scores from 37% to 45%. The self-confidence and social relationships bolt-ons improved the EQ-5D-5L's discrimination between known groups based on self-esteem and bodily appearance (relative efficiency: 2.72 to 2.82).</p><p><strong>Conclusions: </strong>Relevant bolt-ons substantially enhance the psychometric performance of the EQ-5D-5L in MICP populations. The self-confidence and tiredness bolt-ons may be recommended as primary choices for use alongside the EQ-5D-5L, both in clinical studies and as part of sensitivity analyses in economic evaluations of MICPs.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1233-1247"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine measurement in low back pain; towards a pragmatic patient-reported productivity cost outcome measurement using the institute for medical technology assessment productivity cost questionnaire.","authors":"Adekunle Z Ademiluyi, Antoinette D I van Asselt, Michiel F Reneman","doi":"10.1007/s10198-025-01756-9","DOIUrl":"10.1007/s10198-025-01756-9","url":null,"abstract":"<p><strong>Purpose: </strong>The iMTA productivity cost questionnaire (iPCQ) has been recommended as a measurement tool for productivity cost, however, its use in routine care is hindered by the length of this questionnaire (18 questions). This study developed and tested a short-form (SF-) iPCQ.</p><p><strong>Method: </strong>A secondary analysis of the Groningen Spine Cohort's baseline data from patients with low back pain referred for tertiary care was performed. Six SFs were evaluated against the comprehensive iPCQ. Spearman correlation (r), intraclass correlation coefficient (ICC, agreement), standard error of measurement (SEM), and Bland-Altman's plot tested the congruence of the SFs with the comprehensive iPCQ.</p><p><strong>Results: </strong>The sample consisted of 1220 patients with low back pain. The SF version with the highest correlation (SF-3; 7 items) with the comprehensive iPCQ had r = 0.99, ICC = 0.99, SEM = 295, while the SF with the least number of items (SF-6; 5 items) had r = 0.84, ICC = 0.91, SEM = 2063. The mean productivity cost estimates of SF-3 and SF-6 were €3414 (95% CI: 3036-3791) and €3333 (95% CI: 2970-3696) respectively while that for the comprehensive iPCQ amounted to €3456 (95% CI: 3189-3720).</p><p><strong>Conclusion: </strong>A SF with seven questions was developed with a high agreement with the comprehensive iPCQ. Initial clinimetric testing was satisfactory. Further assessment is recommended.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1127-1136"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for health-related quality of life: do they vary by age? A systematic literature review on the EQ-5D measure.","authors":"Alhanouf Alabbad, Madeleine Cochrane, Paul Mark Mitchell","doi":"10.1007/s10198-025-01766-7","DOIUrl":"10.1007/s10198-025-01766-7","url":null,"abstract":"<p><strong>Introduction: </strong>Cost-utility analysis (CUA) is a commonly used method in Health technology assessment (HTA) that utilises generic metrics such as quality-adjusted life years (QALYs). QALY is a measure derived from individuals' preferences for different health states, with these preferences represented as utility values. However, utility values may differ by age, raising equity concerns in healthcare allocation. Given the globally ageing demographic, understanding the age-utility relationship becomes essential.</p><p><strong>Objectives: </strong>This systematic review aimed to explore the impact of age on utility values derived from the EQ-5D, a widely used instrument in CUA that contributes to calculating QALYs by assessing five dimensions of health: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.</p><p><strong>Methods: </strong>Our search used the comprehensive pearl growing approach and database searching. We included studies that analysed the effect of age on EQ-5D utility values in the general population. We excluded qualitative, non-English, and non-EQ-5D instrument studies. Quality was appraised using the Joanna Briggs Institute tool, and a narrative synthesis was used.</p><p><strong>Results: </strong>Of the 28 studies reviewed, primarily from Europe and the Americas, the average age of participants ranged from 34.1 and 47.7 years. Around 46% (n = 13) associated older age with lower utility values; 28% (n = 8) with higher utility; and 25% (n = 7) found no consistent relationship between age and utility.</p><p><strong>Discussion: </strong>Age was identified as a critical factor affecting EQ-5D-derived utility values, with implications for the equitable distribution of healthcare resources. These findings corroborate previous research on utility measurement across different instruments, highlighting the ethical and policy issues due to age-related utility differences.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1275-1291"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in spending, quality indicators, and provider experiences following the introduction of a population-based payment model in dutch primary care: a mixed methods evaluation.","authors":"Tadjo Gigengack, Daniëlle Cattel, Frank Eijkenaar","doi":"10.1007/s10198-025-01765-8","DOIUrl":"10.1007/s10198-025-01765-8","url":null,"abstract":"<p><strong>Background: </strong>In July 2017, a Dutch health insurer and primary care organization jointly implemented the All-In Contract (AIC), a population-based payment model for general practitioners (GPs). Affiliated GP-practices received a capitated payment per enrolled patient covering all GP care and multidisciplinary primary care for chronic conditions. Additionally, the care organization shared in savings and losses on total healthcare spending, contingent upon meeting quality targets. This study investigates the AIC's impact on spending, quality indicators, and provider experiences 2.5 years after implementation.</p><p><strong>Methods: </strong>We employed a difference-in-differences approach comparing individual-level claims spending from enrollees of participating GP-practices (N = 16,425) with a control group (N = 212,251). Changes in indicators of chronic care management and patient satisfaction were investigated in a before-after analysis due to limited data availability. To contextualize the findings and explore provider experiences, focus groups were conducted with stakeholders involved in the development and/or implementation of the AIC.</p><p><strong>Results: </strong>The AIC was associated with an insignificant 1.2% reduction of average quarterly total spending per enrollee (p = 0.476). We did find a - 10.2% decrease in primary care spending growth (p < 0.01), which was likely related to the indexation rate used for the capitation payment. Spending in other subcategories showed insignificant changes. Changes in patient satisfaction and chronic care management indicators were mixed and modest, but due to the lack of data from non-participating GPs, the extent to which these changes can be attributed to the AIC remains uncertain. The focus group participants reported improvements in provider flexibility in care provision, autonomy, and reduced administrative burdens. However, the focus group results may not fully capture the broader or more diverse experiences of all providers involved.</p><p><strong>Conclusions: </strong>In its first 2.5 years, the AIC had no significant effect on total healthcare spending growth. Trends in quality indicators suggest mixed results for patient satisfaction and chronic care management, while focus group results indicated improved provider experiences. To comprehensively evaluate population-based payment reforms, stakeholders should improve data collection strategies to enable causal assessment of population health, patient experiences, and provider well-being.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1191-1208"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing a heterogeneous chronic patient population for redesigning person-centred bundled payment models using risk-mitigating measures.","authors":"Sterre S Bour, Lucas M A Goossens, Maureen P M H Rutten-van Mölken","doi":"10.1007/s10198-025-01762-x","DOIUrl":"10.1007/s10198-025-01762-x","url":null,"abstract":"<p><p>Since 2010, most Dutch patients with diabetes mellitus type 2 (DM2), an increased risk of cardiovascular diseases (CVR), and chronic obstructive pulmonary disease (COPD), have been treated in single-disease management programs (SDMPs) provided by primary care cooperatives (PCCs). These SDMPs are funded through bundled payments. However, given the prevalence of multimorbidity among patients, there is a growing need for care that is more person-centred. We have previously published an alternative payment model that stimulates the integration of care required for a person-centred approach and in this paper, we demonstrate an operationalization of this model. We performed cluster analysis on claims data to distinguish between different subgroups of patients, predicted cluster probabilities with data available to general practitioners, designed different care packages and investigated the expected financial risk for PCCs of different sizes. We showed that mainly the size of the PCC and the content of the care package influenced the predicted losses or profits for the PCC. Two risk-mitigating measures-risk-adjustment and cost-capping-resulted generally in predicted losses or profits closer to 0, and therefore a reduced risk for the PCC.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1249-1262"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public versus private healthcare systems in the OECD area- a broad evaluation of performance.","authors":"Per Molander","doi":"10.1007/s10198-025-01767-6","DOIUrl":"10.1007/s10198-025-01767-6","url":null,"abstract":"<p><p>Healthcare systems can be categorised along the public/private axis into two main types: publicly administered systems and systems based on compulsory health insurance provided by the private sector. Within the OECD area, the latter group has expanded over time, particularly with the inclusion of new member states from Eastern Europe and Central and Latin America. This study compares the efficiency of these two models across the 38 member countries, utilising a broad spectrum of performance indicators developed by the OECD secretariat. Data from the most recent available year, typically 2021, were analysed. On average, performance improves with an increase in healthcare budgets; however, further enhancements come at rising costs. The analysis concludes that there is no evidence supporting the hypothesis that transitioning from a publicly administered system to a privately dominated system will enhance efficiency. By contrast, there is strong evidence that overall efficiency increases with the public share of financing. These conclusions also hold true for the more restricted group of OECD countries in Europe.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1163-1173"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test-retest reliability of the Online Elicitation of Personal Utility Functions (OPUF) approach for valuing the EQ-HWB-S.","authors":"Aisha Moolla, Paul Schneider, Ole Marten, Clara Mukuria, Tessa Peasgood","doi":"10.1007/s10198-025-01769-4","DOIUrl":"10.1007/s10198-025-01769-4","url":null,"abstract":"<p><strong>Introduction: </strong>The EQ Health and Wellbeing Short (EQ-HWB-S) is a new 9-item instrument designed to generate utility values. However, its length makes traditional preference elicitation challenging. The Online elicitation of Personal Utility Functions (OPUF) approach has been tested as a potential solution. This study aimed to assess the test-retest reliability of OPUF for valuing the EQ-HWB-S.</p><p><strong>Methods: </strong>The OPUF survey was administered twice, two weeks apart, to 220 German participants, including 73 from the general population and 147 patients with diabetes or rheumatic disease. Test-retest reliability was evaluated at individual and aggregate levels, examining dimension rankings, swing weights, level weights, and anchoring factors. Continuous data were analysed using the intraclass correlation coefficient (ICC), and ranking data were compared using Spearman's correlation coefficient. Individual and aggregate level utility decrements were assessed using ICC and t-tests.</p><p><strong>Results: </strong>Approximately 36% of participants had significantly correlated dimension ranks, with 42% selecting the same top-ranked dimension. Poor agreement was shown in 70% of ICC values for individual dimension swing weights. For intermediate level weights, ICC values showed poor agreement in 70% and moderate agreement in 30% of responses. The kappa for individual pairwise comparison tasks was 0.64 (95% CI: 0.54-0.75) showing moderate agreement; however, the ICC for individual-level anchoring factors was 0.12 (p < 0.05), indicating poor agreement. Aggregate utility decrements across dimensions were similar.</p><p><strong>Conclusion: </strong>The OPUF approach generates reliable aggregate value sets for the EQ-HWB-S, but further exploration is needed to understand and address the reasons behind inconsistencies at the individual level.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1175-1190"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of medication adherence with treatment preferences: incentivizing truthful self-reporting.","authors":"Carina Oedingen, Raf van Gestel, Samare P I Huls, Georg Granic, Esther W de Bekker-Grob, Jorien Veldwijk","doi":"10.1007/s10198-025-01760-z","DOIUrl":"10.1007/s10198-025-01760-z","url":null,"abstract":"<p><strong>Objective: </strong>Self-reported medication adherence may be influenced by socially desirable answers and untruthful reporting. Misreporting of adherence behavior can bias estimations of treatment (cost)effectiveness. This study investigated how to induce truthful self-reported medication adherence and evaluated how self-reported (truth-induced vs. regularly reported) medication adherence and treatment preferences were associated.</p><p><strong>Methods: </strong>Medication adherence was measured after a discrete choice experiment eliciting stated preferences for Multiple Sclerosis (MS)-treatments. Data was collected among MS-patients in three Western countries. Half of the sample was randomized to 'choice-matching', a novel mechanism which induces truthfulness. It financially compensates respondents based on their self-reported adherence and guesses about other respondents' adherence. To investigate the impact of truth-incentivized adherence reporting on preference heterogeneity, interaction effects between medication adherence and treatment preferences were tested separately within the choice-matching and the 'standard' group.</p><p><strong>Results: </strong>The sample comprised 380 MS-patients (mean age 41y, 69% female). Respondents in the choice-matching group reported a lower medication adherence compared to the standard group (always adherent: 39.3% vs. 46.6%). Mixed logit models showed significant interaction effects: in the choice-matching group, higher medication adherence resulted in lower utility for pills twice/day compared to injections three times/week (p = 0.019), while in the standard group, respondents with higher medication adherence preferred pills once/day compared to injections three times/week (p = 0.005).</p><p><strong>Conclusion: </strong>Choice-matching likely encouraged respondents to report their true medication adherence. Linking truthful behavior to patients' preferences allows for a better understanding of preference heterogeneity and helping to make decisions that fit patients' true preferences.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1219-1232"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Price transparency in the Dutch market-based health care system: did price dispersion for similar hospital services reduce over time?","authors":"Frédérique Franken, Rudy Douven, Stéphanie van der Geest, Marco Varkevisser","doi":"10.1007/s10198-025-01759-6","DOIUrl":"10.1007/s10198-025-01759-6","url":null,"abstract":"<p><p>In market-based health care systems, insurers negotiate prices of hospital care products with providers. While few countries disclose these negotiated prices, in 2016, the Dutch government required the disclosure of insurer-provider negotiated prices for hospital products up to €885 - the maximum deductible in the Netherlands - to enhance price transparency. This aimed to increase price awareness among and price transparency for consumers, insurers, and providers, fostering price competition. We study if price dispersion for relatively homogeneous hospital care products decreased post-publication, resulting in price convergence. We used negotiated price data from three major Dutch health insurers on over 200 hospital products. Using descriptive statistics and linear regression, with the coefficient of variation (a measure of dispersion) regressed on the year, we examined the development of price dispersion and the occurrence of price convergence. Price dispersion for the studied sample of hospital products decreased by an average of 29% between 2016 and 2022. This decrease was not accompanied by a price level increase that was larger than expected based on general inflation. Regression analysis showed a significant negative association between year and the coefficient of variation, indicating price convergence. These findings support our hypothesis that price dispersion decreased after mandatory price disclosure. The government mandate potentially increased awareness of largely unexplainable price differences for products priced below €885, encouraging insurers and providers to reduce these through the negotiation process. The observed price convergence likely benefits patients, as it results in less random out-of-pocket payments across providers for the same hospitals products.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1137-1147"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of parastomal hernia on quality of life using data from the CIPHER prospective cohort study.","authors":"Joel Glynn, William Hollingworth, Jessica Harris, Syed Mohiuddin, Lucy Ellis, Barnaby C Reeves, Neil Smart","doi":"10.1007/s10198-025-01768-5","DOIUrl":"10.1007/s10198-025-01768-5","url":null,"abstract":"<p><strong>Objectives: </strong>Despite being a common side effect of stoma surgery, little is known about the health-related quality-of-life (HRQoL) impact of parastomal hernia (PSH). We studied the association between HRQoL and self-reported PSH using data from the large CIPHER prospective cohort study of patients living with a stoma.</p><p><strong>Methods: </strong>Over 12 months, HRQoL was captured at up to four time points for 2,341 individuals with stomas using EuroQol-5D-5L (EQ-5D-5L). Applying a repeated measures regression, we analysed the association between HRQoL and the incidence of self-reported PSH in the year following surgery. Using ordinal regressions, we estimated the odds of reporting worse function in each of the five EQ-5D-5L dimensions among those reporting PSH. We estimated the average number of quality-adjusted life days (QALDs) lost in those reporting PSH.</p><p><strong>Results: </strong>Patients experiencing PSH reported significantly lower EQ-5D-5L scores at 12 months following stoma formation (-0.099 [95%CI: -0.126 to -0.071]), amounting to 22.3 QALDs lost per-person-per year. Patients reporting PSH at 12 months had more problems in all EQ-5D-5L dimensions. In four of five dimensions, patients with PSH had more than double the odds of reporting worse HRQoL levels; the difference was most substantial for pain/discomfort (odds ratio 2.80 [95%CI: 2.17 to 3.62]).</p><p><strong>Conclusion: </strong>Developing PSH significantly reduces HRQoL across a range of health outcomes, including pain/ discomfort, usual activities, self-care, mobility, and anxiety/depression. Therefore, developing and evaluating surgical techniques to prevent PSH is important to reduce the prevalence of PSH following stoma formation. Estimates of HRQoL presented here can be used in cost-effectiveness studies evaluating such interventions.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1209-1218"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}