European Journal of Health Economics最新文献

{"title":"Comparison of the psychometric performance of experimental EuroQol Toddler and Infant Populations Instrument (EQ-TIPS) and Pediatric Quality of Life Inventory™ (PedsQL) in young children.","authors":"Tianxin Pan, Li Huang, Vicky He, Janine Verstraete, Nancy Devlin, Mike Herdman, Kim Dalziel","doi":"10.1007/s10198-025-01804-4","DOIUrl":"https://doi.org/10.1007/s10198-025-01804-4","url":null,"abstract":"","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of the covered endovascular reconstruction of the aortic bifurcation versus kissing stents and open surgical repair for the treatment of aorto-iliac occlusive disease.","authors":"Xavier G L V Pouwels, Suzanne Holewijn, Daphne van der Veen, Mauricio Gonzalez-Urquijo, Michel M P J Reijnen, Hendrik Koffijberg","doi":"10.1007/s10198-025-01792-5","DOIUrl":"https://doi.org/10.1007/s10198-025-01792-5","url":null,"abstract":"<p><strong>Objective: </strong>To assess the cost effectiveness of the Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) versus kissing stents (KS) and open surgical repair (OSR) for treating extensive aorto-iliac occlusive disease (AIOD).</p><p><strong>Methods: </strong>A decision tree followed by a health state transition model was developed to simulate changes in Rutherford status and the occurrence of reinterventions, amputation, and death. A Dutch health care perspective and a five-year time horizon were used. Model inputs were estimated using non-randomised data of individuals who underwent a CERAB or a KS procedure and literature. The total number of reinterventions, life years, quality-adjusted life years (QALYs) and health care costs per strategy were calculated as well as the incremental costs and QALYs between strategies, and corresponding incremental cost-effectiveness ratios (ICERs).</p><p><strong>Results: </strong>OSR resulted in the lowest survival due to a higher peri-operative probability of death. OSR resulted in a lower probability of reinterventions (6%, 95% Confidence Interval (CI): 1-15%) than CERAB (17%, 95%CI: 11-27%) and KS (29%, 95%CI: 17-46%). CERAB dominated OSR since it led to 0.032 (95%CI: -0.038-0.082) incremental QALYs and €-11,466 (95%CI: €-18,934-€-3,415) incremental costs versus OSR. CERAB led to 0.048 (95%CI: 0.011-0.109) incremental QALYs, €5,324 (95%CI: €2,938-€10,397) incremental costs, and an ICER of €110,201 per QALY versus KS.</p><p><strong>Conclusions: </strong>CERAB dominated OSR and resulted in the highest health benefits and costs but does not seem to be cost effective versus KS for treating AIOD. Performing a randomised comparison of these treatment modalities is essential to confirm these findings.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of using constrained regression in Germany's morbidity-based risk adjustment.","authors":"Florian Renker, Dennis Häckl, Amelie Wuppermann","doi":"10.1007/s10198-025-01819-x","DOIUrl":"https://doi.org/10.1007/s10198-025-01819-x","url":null,"abstract":"<p><p>Risk adjustment schemes are meant to compensate health plans adequately for their enrollees' expected health care costs so as to prevent incentives for risk selection in competitive health insurance systems with restrictions on risk-rating of premiums. However, important under-/overcompensation for specific groups of enrollees persists in many of the current risk adjustment schemes in place. While for some groups, a direct inclusion of the group in the risk adjustment scheme can solve this issue, others cannot be included in the scheme, e.g. because the status is not observed for every enrollee. Van Kleef et al. (Eur. J. Health Econ. 18, 1137-1156 (2017)) suggest constrained regression as a remedy. In this paper, we explore constrained regression in the context of the German morbidity-based risk adjustment scheme. We find that constrained regression is technically feasible in the German context and has the potential to improve upon the current base model in terms of overall under-/overcompensation and even individual model fit, particularly if the constraint is not set to fully eliminate under-/overcompensation in the respective group but to only partial elimination. Before implementation of constrained regression, a policy-discussion on which groups should be included in constructing an overall measure of under-/overcompensation is needed.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valuing health and wellbeing using discrete choice experiment: exploring feasibility, design effect and international preference similarity.","authors":"Haode Wang, Donna L Rowen, Yuen Chen, Clara Mukuria, Deborah Street, Richard Norman","doi":"10.1007/s10198-025-01821-3","DOIUrl":"https://doi.org/10.1007/s10198-025-01821-3","url":null,"abstract":"<p><strong>Background: </strong>Discrete choice experiments (DCEs) are increasingly used in health preference elicitation studies. However, few studies have explored applying a DCE to value long health and wellbeing measures. This study evaluates feasibility, examines the impact of attribute ordering and explores if similar preference exists between countries.</p><p><strong>Methods: </strong>A health and wellbeing classification system was derived from the EQ Health and Wellbeing (EQ-HWB) measure based on dimensionality, item performance, stakeholder preference and cultural feasibility. Representative samples of UK and Australian general population completed 13 DCE_TTO tasks. Feasibility was assessed using data quality, time spent on the survey and each task, logical consistency and respondent understanding. Data were modelled using conditional logit model, to evaluate feasibility and impact of attribute ordering (health or other attributes ordered first). The UK and Australian value sets were compared on key characteristics, such as the relative importance of attributes, value set length and distribution.</p><p><strong>Results: </strong>2489 UK and Australian general public respondents completed the online DCE_TTO survey. Participants reported good understanding of the DCE_TTO questions and the attributes. Most of the more severe dimension levels had increasing disutility, with a higher proportion of insignificance observed with the wellbeing attributes. Physical health attributes had larger disutility than other attributes, with anchored utility values ranging from - 0.791 to - 0.588 to 1 for UK and Australian population. The preference between the two countries differed, with mixed evidence for ordering effects.</p><p><strong>Conclusions: </strong>DCE_TTO is a viable method for health and wellbeing preference valuation. However, health and wellbeing preference can be influenced by attribute ordering and national setting. The results have implications for the development of future health and wellbeing valuation studies.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nothing about us, without us? A reflection on and call for involving children in the process of valuing child health.","authors":"Ava Hoogenboom, Vivian Reckers-Droog, Stefan Lipman, Werner Brouwer","doi":"10.1007/s10198-025-01823-1","DOIUrl":"https://doi.org/10.1007/s10198-025-01823-1","url":null,"abstract":"<p><p>A key question in economic evaluation is whose preferences health-related quality of life (HRQoL) values should be based on. This question becomes increasingly prominent and complex when it comes to the evaluation of health interventions aimed at children, as this requires the valuation of child health states. Resulting discussions have focused on whose preferences should be elicited, from what perspective, and how - highlighting important challenges. As opposed to current EQ-5D-Y protocol (i.e., valuation of child health states by adult members of the public), this paper explores the potential involvement of children in the process of valuing child health. We identified arguments for public involvement in healthcare decision-making in the broader literature and examined their relevance to involving children in the health state valuation (HSV) process. Overall, in line with recent empirical findings, the arguments provide a basis for broadly exploring the involvement of children. Given the concerns regarding the direct involvement of children in HSV tasks, we call for a shift of thinking in two ways: children can be involved in the process of coming to HRQoL values in more ways than only HSV tasks, and the focus should move from whether children should be involved in HSV to exploring how they can be involved.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling heterogeneity in efficiency measurements: a case study of public hospitals in Spain.","authors":"Marta Arbelo-Pérez, Violeta De Vera, Antonio Arbelo","doi":"10.1007/s10198-025-01818-y","DOIUrl":"https://doi.org/10.1007/s10198-025-01818-y","url":null,"abstract":"<p><p>Understanding efficiency in the hospital setting is now recognized as a fundamental pillar for making informed decisions and is crucial to ensuring the sustainability of health care systems. However, a significant portion of the literature assessing efficiency in the hospital sector tends to overlook heterogeneity across hospitals, leading to a notable bias in inefficiency estimation. In this paper, a stochastic frontier Bayesian model with random coefficients was used to estimate cost efficiency in the hospital sector, assuming heterogeneity across hospitals. The sample included 278 public hospitals in Spain during the period 2016-2019. The results revealed that public hospitals in Spain operate at a medium level of cost inefficiency of 12.86%, with this inefficiency being overestimated by 9.2% points if heterogeneity across hospitals is not adequately considered. This result underscores the importance of incorporating heterogeneity across hospitals in the evaluation of hospital efficiency to obtain accurate and reliable estimates.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of health and well-being from a societal perspective: A willingness to pay experiment in the Netherlands.","authors":"Karen Trujillo Jara, Daphne C Voormolen, Werner Brouwer, Job van Exel","doi":"10.1007/s10198-025-01814-2","DOIUrl":"https://doi.org/10.1007/s10198-025-01814-2","url":null,"abstract":"<p><p>Interpreting the results of cost-effectiveness analyses requires a threshold value for the costs per quality-adjusted life year (QALY). The first empirical studies that estimated this threshold value from a societal perspective in the Netherlands were conducted 10 years ago. This paper is aimed at estimating the social willingness to pay (WTP) per QALY and per well-being adjusted life year (WALY); investigating how the societal value of a QALY changed over the course of about ten years and comparing the WTP for well-being relative to health from a societal perspective. In this study, the contingent valuation approach was used, in which QALYs and WALYs were valued under uncertainty and corrected for probability weighting. The estimates obtained in a representative sample of the Dutch population ranged from €27,800 to €95,300 per QALY, depending on the specification of the societal perspective. The value of health found in the SOC and SII versions of this study, nominally, were between 6.1% and 33.4% higher than the values found 10 years ago. Moreover, the estimates per WALY ranged from €88,500 to €349,500. Finally, our results show that a year in full well-being was valued between 2.95 and 4.35 times higher than a year in full health.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in patients with alcohol use disorder: comparing instruments and mapping from clinical measures to preference-based measures.","authors":"Eva Rodríguez-Míguez, Jacinto Mosquera","doi":"10.1007/s10198-025-01816-0","DOIUrl":"10.1007/s10198-025-01816-0","url":null,"abstract":"<p><strong>Background and objectives: </strong>The impact of alcohol use disorder (AUD) on quality of life can be quantified by generic and specific measures. This study's aims are to compare different preference-based instruments to measure health-related quality of life (HRQoL) in patients with AUD and to examine their relationship with alcohol-specific measures used in the clinical setting.</p><p><strong>Methods: </strong>A sample of 259 patients with AUD were recruited from a Spanish alcoholism unit. We administered EuroQoL-5Dimension -5levels (EQ-5D), ShortForm-6Dimension (SF-6D), AlcoholQuality-of-life-4Dimension (AlcQ-4D), Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and Alcohol Use Disorders Identification Test (AUDIT) instruments at the beginning of treatment and 12 months thereafter. Differences in HRQoL instruments scores were estimated and their capacity to discriminate among known clinical severity groups was analysed. Several mapping functions were tested to transform scores from the clinical setting (AUDIT or DSM-5) into HRQoL scores (EQ-5D, SF-6D or AlcQ-4D).</p><p><strong>Results: </strong>HRQoL scores are sensitive to the instrument used. Mean scores are always highest using EQ-5D, followed by SF-6D and AlcQ-4D. All HRQoL instruments discriminate among clinical severity groups defined using DSM-5 or AUDIT. Although several mapping functions were estimated, those using the total score of the clinical instruments were selected.</p><p><strong>Conclusion: </strong>The results suggest that clinical measures used in the field of AUD could be adapted for use in economic evaluation. However, the incremental cost-utility ratio of AUD programs, and hence the policy decisions derived from it, may depend on the HRQoL instrument used.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Willingness to pay for measures to increase use of active school transport.","authors":"Kristina Ek, Anna-Karin Lindqvist, Ellen Gustavsson Niemi, Stina Rutberg, Nadja Sirviö","doi":"10.1007/s10198-025-01811-5","DOIUrl":"https://doi.org/10.1007/s10198-025-01811-5","url":null,"abstract":"<p><p>The societal gains from increased physical activity among children are substantial. This study aims to contribute with knowledge about how the benefits of increased physical activity are valued by the Swedish general public. The methodological approach is a contingent valuation survey (n = 768), which allows to capture values associated with increased physical activity that extend beyond the health domain. To our knowledge, this is the first study using a contingent valuation approach to assess the comprehensive benefits of promoting physical activity. Although almost all respondents support the idea to promote active school transport in general, slightly more than half the sample reject the idea to contribute financially, while almost half the sample state a positive willingness to pay (WTP), and only approximately 10% state a positive WTP without uncertainty. The average WTP a lump sum for the intervention is estimated to lie between SEK64-185 (approximately 6-19 Euros). Higher WTP correlates with income, perceptions that lack of physical activity as a serious problem, and regular exercise engagement. Due to limited access to cost data, a full economic evaluation is not possible. Nevertheless, even using lower-bound WTP (uncertain = 0), aggregate benefits exceed teacher-time costs, which are expected to constitute the most important part of intervention costs. Policymakers are recommended to implement low-cost interventions to increase physical activity of children, for instance by promoting the use of active school transport.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valuing health states for infants and toddlers: challenges and methodological considerations in EQ-TIPS preference elicitation.","authors":"Nancy Devlin, Bram Roudijk, Michael Herdman, Elly Stolk, Richard Norman, Simone Kreimeier, Janine Verstraete","doi":"10.1007/s10198-025-01789-0","DOIUrl":"https://doi.org/10.1007/s10198-025-01789-0","url":null,"abstract":"<p><p>Many health care interventions are aimed at very young children, including public health measures such as vaccines, and new, high-cost medicines for rare diseases. This has led to increasing interest in evidence on the effectiveness and cost effectiveness of treatments in this age group. EQ-TIPS has been developed as a concise, generic health outcomes measure in 0-3-year-olds. Preference weights for EQ-TIPS are required to facilitate its use in economic evaluation. The aim of this paper is to consider the issues likely to be encountered in attempts to elicit stated preferences for EQ-TIPS. We begin by identifying the challenges that would arise if the existing EQ-5D-Y-3L ('Y-3L') valuation protocol were used as a starting point to value EQ-TIPS states. We highlight the challenges specific to valuing EQ-TIPS over and above the challenges already noted in valuing the Y-3L. We then discuss broader issues that may arise in valuing EQ-TIPS: (a) the potential influence on values of respondents taking into account the future consequences of developmental delay arising from poor health in infants, and (b) spill-over effects of poor health in infants on parents/caregivers. Methods used in valuing other instruments in this age group are reviewed. We conclude that eliciting stated preferences for EQ-TIPS would require adapting existing valuation methods. Parent-based valuation may be a viable approach, although methodological complexities remain. Alternative means of preference weighting EQ-TIPS, including mapping to the EQ-5D-Y, may offer a way forward.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}