Applied Health Economics and Health Policy最新文献

{"title":"Evaluating Access Improving Interventions: An Economic Evaluation of Surgical Task-Shifting for C-Sections in Sierra Leone.","authors":"Bryony Dawkins, Bethany Shinkins, Tim Ensor, David Jayne, Thomas Ashley, Alex J van Duinen, Håkon A Bolkan, David Meads","doi":"10.1007/s40258-025-00965-w","DOIUrl":"10.1007/s40258-025-00965-w","url":null,"abstract":"<p><strong>Background: </strong>Access to safe, timely and affordable surgical care is lacking globally. Less than 6% of all surgical operations are carried out in low- and middle-income countries, where over a third of the world's population lives. CapaCare, an NGO operating in Sierra Leone, have developed a surgical training programme (STP) for Associate Clinicians based on principles of task-shifting to improve access. Interventions to increase healthcare access have the same value evidence requirements as new technologies but their evaluation presents methodological challenges as access is not routinely incorporated explicitly in economic evaluations.</p><p><strong>Objective: </strong>To evaluate the cost-effectiveness of surgical task-shifting in Sierra Leone, implemented through the CapaCare STP, to increase provision of caesarean section (C-section).</p><p><strong>Methods: </strong>We evaluated the impact of the STP on the provision of C-section and subsequent maternal and child outcomes, measured in disability-adjusted life-years (DALYs), relative to the costs using a healthcare system perspective and decision-tree model parameterised using data from surgical logbooks, national data, and the literature.</p><p><strong>Results: </strong>Results indicate that the surgical task-shifting programme in Sierra Leone would be considered cost-effective in increasing provision for C-section. It is cost saving (USD - 16.77) and results in 2.14 DALYs averted, per women with an indication for C-section, due to avoidance of maternal and child deaths as well as reduced complications.</p><p><strong>Conclusion: </strong>Investment in surgical task-shifting initiatives should be considered by policymakers as a potentially cost-effective way to increase access to quality surgical services. Future evaluations of access-increasing interventions should seek to capture the distributional impact of this strategy and system benefits.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":"705-723"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cost and Cost-Effectiveness of Childbirth Settings: A Systematic Review.","authors":"Vanessa Scarf, Habtamu Kasaye, Kate Levett, Emily Callander","doi":"10.1007/s40258-025-00957-w","DOIUrl":"10.1007/s40258-025-00957-w","url":null,"abstract":"<p><strong>Background: </strong>To sustain positive progress toward sustainable development goals as envisioned in goal 3 and beyond, safe and affordable care during pregnancy and birth for women, their families, and health facilities and professionals is essential. In this systematic review, we report the best available evidence regarding the cost and cost-effectiveness of birth in various settings, including hospitals, birth centres, and homes for women at low risk of complications from high-, middle-, and low-income countries.</p><p><strong>Methods: </strong>We conducted a systematic review of cost and economic evaluation papers, following the comprehensive search of online databases, including Medline, CINAHL, Embase, Scopus, and Google Scholar, and grey literature, using predetermined search strategies. Both partial and full economic evaluation studies were included, and we appraised them using Joanna Briggs Institute's (JBI's) critical appraisal checklists for economic evaluation studies. Although we attempted to pool total incremental net benefit, the results were synthesised narratively without a meta-analysis due to the high heterogeneity between primary studies.</p><p><strong>Findings: </strong>From 2307 identified studies, 11 studies (13 country level records from 11 countries) were included. Both direct and indirect costs of childbirth at home, midwife-led birth units (MLBUs), and hospitals were reported. Ten studies showed that births in MLBUs were less costly than hospital births, while home births were also reported to be less costly than hospital births in seven studies. Regarding cost-effectiveness, in Bangladesh, MLBUs generally showed better outcomes at lower costs than hospital births, while one site had higher costs. In Pakistan and Uganda, MLBUs displayed mixed results, with some being cost-effective and others more costly with poorer outcomes. In the Netherlands, MLBUs were less costly but had poorer outcomes, whereas home births were less costly and more effective. In Belgium, MLBUs were less costly but less effective in reducing caesarean and instrumental births, though they did reduce epidural analgesia use cost-effectively.</p><p><strong>Conclusions: </strong>Most studies found that births in MLBUs and at home were less costly than births in hospital. There is the potential for these settings to provide a cost-effective option for women through reduced intervention rates and favourable outcomes in high-income countries and could offer birthing options to women in low- and middle-income countries that includes care by skilled maternity practitioners in potentially more affordable settings.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":"551-568"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GaitSmart Rehabilitation Exercise Programme for Gait and Mobility Issues: A NICE Medical Technologies Guidance.","authors":"Huey Yi Chong, Michal Pruski, Megan Dale, Rhys Morris","doi":"10.1007/s40258-025-00955-y","DOIUrl":"10.1007/s40258-025-00955-y","url":null,"abstract":"<p><p>GaitSmart (Dynamic Metrics Ltd) is a class I CE-marked sensor-based digital technology designed to measure lower limb movement via sensors placed on the body. GaitSmart aims to identify any problems with gait, and provide a personalised rehabilitation programme via the integrated vGym app. The company identified people referred for knee or hip replacement and people at risk of falling as potentially being able to benefit from GaitSmart. The clinical evidence identified was limited in its applicability to the scope of the assessment, and there was large variability in the comparators used in these studies and in the current care pathways, especially for people at risk of falls. There is some limited evidence that patients like the report generated by the technology and found it helpful in understanding their condition. Clinical experts thought GaitSmart had the potential to improve outcomes for patients and could be used in the community setting by a range of healthcare professionals. Economic modelling over a 1-year time horizon from a UK National Health Service (NHS) perspective for the falls model and a 17-week horizon for the rehabilitation model indicate that GaitSmart is cost saving; however, this is dependent on the model of standard care. Where GaitSmart is delivered by trained healthcare assistants, it would lead to a reduction in staff time costs compared to most alternative standard care options. Uncertainty is greater in the falls model given the high variability in standard care. In April 2024, the National Institute for Health and Care Excellence recommended that GaitSmart can be used to treat gait and mobility issues in adults at risk of falls, while more evidence is gathered. For adults having hip or knee replacements, access to GaitSmart should be via the company, research or non-core NHS funding, with appropriate management of any risks.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":"625-637"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Use of Unanchored Matching-Adjusted Indirect Comparison Always Superior to Naïve Indirect Comparison on Survival Outcomes? A Simulation Study.","authors":"Ying Liu, Xiaoning He, Jia Liu, Jing Wu","doi":"10.1007/s40258-025-00952-1","DOIUrl":"10.1007/s40258-025-00952-1","url":null,"abstract":"<p><strong>Objective: </strong>To compare the performance of matching-adjusted indirect comparison (MAIC) and naïve indirect comparison (NIC) under a wide range of data scenarios on survival outcome.</p><p><strong>Methods: </strong>A simulation study included 729 (3⁶) single-arm trial data scenarios, which were created by performing a three-level full factorial arrangement of six situational variables, including individual patient data (IPD) sample size, aggregate data (AgD) sample size, covariate strength, covariate correlation, covariate overlap, and relative treatment effect. In each scenario, 1000 repetitions of simulated datasets were generated using the Monte Carlo approach. MAIC and NIC methods were used to estimate the relative treatment effect of each simulated dataset. The performance was evaluated in terms of bias, empirical standard error (ESE), mean squared error (MSE), and confidence interval coverage, respectively.</p><p><strong>Results: </strong>MAIC yielded relatively unbiased estimates of relative treatment effect compared with NIC in most scenarios, with better coverage and MSE but higher ESE. None of the situational variables had a significant impact on the bias and coverage of MAIC. However, increasing IPD sample size and covariate overlap significantly reduced the ESE and MSE of MAIC. In scenarios with low covariate overlap and high covariate strength, the bias of MAIC was larger and even greater than that of NIC.</p><p><strong>Conclusions: </strong>The performance of MAIC consistently demonstrates advantage over NIC across various scenarios. MAIC often provides more unbiased estimates and achieves confidence interval coverage close to nominal values compared with NIC. While MAIC may exhibit higher ESE in specific scenarios, this additional uncertainty can offer a more accurate reflection of variability, enhancing the robustness of the results. Researchers should thoroughly comprehend the influencing factors and interactions affecting the performance of these methods and judiciously apply research findings.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":"693-704"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priority Setting in the Context of Planetary Healthcare.","authors":"Glory O Apantaku, Lydia Kapiriri, Ole F Norheim, Ingrid Cardoso Couto de Azevedo, Dan Kim, Martin Hensher, Jaithri Ananthapavan, Anand Bhopal, Andrea J MacNeill, Jodi D Sherman, Craig Mitton","doi":"10.1007/s40258-025-00980-x","DOIUrl":"https://doi.org/10.1007/s40258-025-00980-x","url":null,"abstract":"<p><p>The realities of ecosystem breakdown and climate change pose a significant threat to the health of individuals around the world, disproportionately affecting poor and vulnerable populations. Every sector in society, including healthcare, needs to be engaged in the tremendous collective effort and transformational change needed to limit global warming. We see priority setting as having a key role to play in reallocating existing budgets within healthcare systems whilst at the same time being used to facilitate sustainable and more efficient resource allocation across countries. Priority setting looks to fairly distribute resources with the goal of improving patient and population health outcomes. However, these goals can be broadened to include consideration of environmental impact based on our understanding of the necessity of emissions reduction to address the climate crisis and promote population health. In this paper, we introduce key concepts of priority setting and identify the interplay between priority setting and the realities of resource scarcity in the realm of planetary healthcare. We propose that applying priority-setting principles could serve at least three goals; (1) protect and improve health outcomes; (2) limit unnecessary and marginal care; and (3) facilitate a just transition to a sustainable healthcare system.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Technology Assessment and Environmental Impact: A Scoping Review of State of Art and Future Perspective.","authors":"Ippazio Cosimo Antonazzo, Giorgia Gribaudo, Lisa Ye, Pietro Ferrara, Lorenzo Losa, Paolo Abrate, Fabio Iraldo, Lorenzo Giovanni Mantovani, Paolo Angelo Cortesi","doi":"10.1007/s40258-025-00984-7","DOIUrl":"https://doi.org/10.1007/s40258-025-00984-7","url":null,"abstract":"<p><strong>Introduction: </strong>Manufacture, distribution, use, excretion, and disposal of health technologies all have environmental impacts (EIs). In the health technology assessment (HTA) definition, EI is recognized as a domain that should be assessed. However, EIs in HTA methods are lacking. The aim of this scoping review was to identify current advances and limitations in incorporating EI in HTA evaluation.</p><p><strong>Methods: </strong>We searched two databases, PubMed and Embase (01/01/2019-20/10/2023, updated on 15/05/2025), using the following keywords: \"HTA\" and \"environmental impact.\" Articles published in English were included. Additionally, no filters by study design or type of evaluated technology were used.</p><p><strong>Results: </strong>In total, 264 studies were screened after duplicates had been removed. Among them, 15 articles were included. Identified publications highlighted the necessity of robust and clear methods of EI assessment and its inclusion in the HTA process. Several authors have outlined the importance of assessing the EI of health technology throughout its life cycle, including raw materials, manufacturing, use, and disposal. However, the EI assessment in HTA presents significant challenges, such as determining a clear domain of EI, the perspective, and the time horizon for the assessment. EI assessment challenges also include the lack of disaggregated data on pollutant emissions and natural resource consumption, as well as recommendations on the use of the EI data by decision makers and HTA agencies. In the literature, different methods and approaches have been proposed to incorporate EI in HTA; some rely on already establish assessment methods (\"enriched\" cost-utility analysis, adjusted willingness to pay, and multicriteria decision analysis) and others proposed more specific approaches, such as \"information conduit,\" \"parallel evaluation,\" \"integrated evaluation,\" and \"environment-focused evaluation.\"</p><p><strong>Conclusion: </strong>HTA framework needs adjustments to incorporate environmental information, including environmental healthcare technology impact. Clear and robust methods on EI assessment and inclusion in the HTA process should be provided by HTA agencies and international societies. Further, manufacturers should improve the data generation on the EI of their products, with new studies able to generate individual-level data on environmental technology impact.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trump's Drug Pricing Order and the Domestic Economic Trade-Off.","authors":"Afschin Gandjour","doi":"10.1007/s40258-025-00986-5","DOIUrl":"https://doi.org/10.1007/s40258-025-00986-5","url":null,"abstract":"","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Health and Economic Effects of a Large-Scale Outpatient Screening and Continuing Care Programme for Early Detection and Care of Microvascular Complications in Patients with Type 2 Diabetes Implemented in Routine Care Across Germany: A Quasi-Experimental Study Using Health Insurance Claims Data.","authors":"Min Fan, Anna-Janina Stephan, Michael Hanselmann, Andreas Lueg, Michael Laxy","doi":"10.1007/s40258-025-00978-5","DOIUrl":"https://doi.org/10.1007/s40258-025-00978-5","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to analyse the real-world health and economic effect of an outpatient screening and continuing-care programme for early detection and care of microvascular complications in patients with type 2 diabetes (T2D) delivered through a selective contract between a large statutory health insurance company and ambulatory care physicians in the German health care system.</p><p><strong>Methods: </strong>Building on methods of target trial emulation and programme impact evaluation, we used a quasi-experimental approach and health insurance claims data from 790,375 patients with T2D over a time horizon of 5.75 years. We applied a two-stage matching approach in which we exploited the staggered implementation of the selective contract across federal states in Germany to control for selection bias at the physician level and used propensity scores to control for selection bias at the patient level, where we considered socio-demographic, health consciousness-related, care-related, and comorbidity-related potential confounders in the matching process.</p><p><strong>Results: </strong>Within a matched sample of 16,490 patients, over 1 year, enrolment into the programme increased the number of visits to primary care physicians (relative risk [RR]: 1.09, 95% confidence interval [CI] 1.07, 1.10), increased the frequency of prescriptions for sodium-glucose cotransporter-2 (SGLT2) inhibitors (RR: 1.30, 95% CI 1.12, 1.50) and for statins (RR: 1.08, 95% CI 1.03, 1.13) and decreased the risk of hospitalisations (RR: 0.88, 95% CI 0.84, 0.92). Outpatient costs in the enrolled patients were on average 14% (cost ratio: 1.14, 95% CI 1.09, 1.20) or €194.4 higher, but overall, the programme was budget neutral over a time horizon of 1 year.</p><p><strong>Conclusion: </strong>Investing in secondary prevention to detect and manage the early stages of microvascular complications is likely a cost-effective or cost-saving approach to improve health in patients with T2D.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrete Event Simulation in R using the 'Simmer' Package for Health Economic Modelling: A Tutorial and Illustration in Colon Cancer.","authors":"Koen Degeling, Jonathan Karnon, Michiel van de Ven, Alan Brennan, Hendrik Koffijberg","doi":"10.1007/s40258-025-00983-8","DOIUrl":"https://doi.org/10.1007/s40258-025-00983-8","url":null,"abstract":"<p><p>Discrete event simulation (DES) provides enhanced flexibility over modelling techniques that have been traditionally used for assessing health-economic outcomes, making it a particularly interesting technique for modelling complex clinical pathways. Discrete event simulation also facilitates consideration of resources and capacity constraints, making it suitable for addressing a wide range of research questions in health care and beyond. However, those unfamiliar with DES often perceive it to be more complex compared to traditional health-economic modelling techniques, such as state-transition modelling. To address this perceived complexity, this tutorial provides a detailed illustration of implementing DES in the open-source R software using the simmer package, through a case study in colon cancer. The tutorial is aimed at those who have a conceptual model that they want to implement as a DES in R, and are looking for practical guidance. It discusses methodological aspects related to DES and individual-level modelling in general that have not been extensively covered in literature, the conceptual model structure and corresponding pseudocode, data analysis, model implementation, and the deterministic and probabilistic analysis of the model. The documented code provides all building blocks required to develop a wide range of DES models in R using the simmer package.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of a Universal School-Based Mental Health Prevention Program: An Economic Modeling Study in a Limited Income Context.","authors":"Ha T Nguyen, Anh Q Nguyen, Nga T Nguyen, Nga L La, Thach Tran, Astrid Wurfl, Jayne Orr, Hau Nguyen, Ian Shochet, Jane Fisher, Huong T Nguyen","doi":"10.1007/s40258-025-00982-9","DOIUrl":"https://doi.org/10.1007/s40258-025-00982-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the cost-effectiveness of a school-based mental health prevention program in a limited income context to inform investment decisions.</p><p><strong>Methods: </strong>The Resourceful Adolescent Program, an evidence-based resilience intervention designed for adolescents, was culturally adapted as Happy House (HH) in a two-arm, controlled trial in selected high schools in Vietnam. A Markov model assessed HH's cost-effectiveness in preventing depression compared with doing nothing from a societal perspective over 5-year, 10-year, and lifetime horizons. The model underwent face, internal, and cross-validation with experts in health economics, mental health, and education. Effect size was drawn from the HH trial, utility values from an EuroQol 5-Dimension 5-Level (EQ-5D-5L) survey of 1004 adolescents and systematic reviews, and costs from the HH trial and Vietnam data. Incremental cost-effectiveness ratios (ICERs) were expressed in 2020 Vietnamese dong (VND) per quality-adjusted life year (QALY) gained, with costs and benefits discounted at 3%. Sensitivity analyses and a scenario on nationwide HH scaling were also conducted.</p><p><strong>Results: </strong>Compared with do-nothing, HH had ICERs of 43.8 million VND (US $5512), 30.4 million VND (US $3831), and 22.9 million VND (US $2886) per QALY gained over 5-year, 10-year, and lifetime horizons, respectively. Nationwide scaling reduced ICERs to 27.6 million VND (US $3470), 18.8 million VND (US $2370), and 13.5 million VND (US $1698) per QALY over the same periods. ICERs were sensitive to changes in effect size, disease incidence, and intervention costs. Sensitivity analyses demonstrated that the results were robust despite parameter uncertainty and variations in key assumptions CONCLUSIONS: Investing in a universal school-based mental health prevention program is cost-effective compared with doing nothing in a limited income context such as Vietnam. Scaling up HH implementation amidst rising depression incidence further enhances the cost-effectiveness of this investment.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}