What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?

The ‘conventional framework’ of economic evaluation, the comparative public sector healthcare costs and quality adjusted life year (QALY) of two or more interventions, has become synonymous with commissioning decisions in many countries. However, while useful as a framework in guiding value-based de...

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Autores principales:	Sebastian Hinde, Helen Weatherly, Gabriella Walker, Lorna K. Fraser
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	end of life palliative paediatric health economics economic evaluation cost effectiveness analysis Medicine R
Acceso en línea:	https://doaj.org/article/d50e6ebad4a347039e09fc46edb2534b
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spelling	oai:doaj.org-article:d50e6ebad4a347039e09fc46edb2534b2021-11-11T16:40:25ZWhat Does Economic Evaluation Mean in the Context of Children at the End of Their Life?10.3390/ijerph1821115621660-46011661-7827https://doaj.org/article/d50e6ebad4a347039e09fc46edb2534b2021-11-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11562https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601The ‘conventional framework’ of economic evaluation, the comparative public sector healthcare costs and quality adjusted life year (QALY) of two or more interventions, has become synonymous with commissioning decisions in many countries. However, while useful as a framework in guiding value-based decisions, it has limited relevance in areas such as end of life care in children and young people, where the costs fall across multiple stakeholders and QALY gains are not the primary outcome. This paper makes the case that the restricted relevance of the ‘conventional framework’ has contributed to the inconsistent and varied provision of care in this setting, and to the knock-on detrimental impact on children nearing the end of their lives as well as their families. We explore the challenges faced by those seeking to conduct economic evaluations in this setting alongside some potential solutions. We conclude that there is no magic bullet approach that will amalgamate the ‘conventional framework’ with the requirements of a meaningful economic evaluation in this setting. However, this does not imply a lack of need for the summation of the costs and outcomes of care able to inform decision makers, and that methods such as impact inventory analysis may facilitate increased flexibility in economic evaluations.Sebastian HindeHelen WeatherlyGabriella WalkerLorna K. FraserMDPI AGarticleend of lifepalliativepaediatrichealth economicseconomic evaluationcost effectiveness analysisMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11562, p 11562 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	end of life palliative paediatric health economics economic evaluation cost effectiveness analysis Medicine R
spellingShingle	end of life palliative paediatric health economics economic evaluation cost effectiveness analysis Medicine R Sebastian Hinde Helen Weatherly Gabriella Walker Lorna K. Fraser What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?
description	The ‘conventional framework’ of economic evaluation, the comparative public sector healthcare costs and quality adjusted life year (QALY) of two or more interventions, has become synonymous with commissioning decisions in many countries. However, while useful as a framework in guiding value-based decisions, it has limited relevance in areas such as end of life care in children and young people, where the costs fall across multiple stakeholders and QALY gains are not the primary outcome. This paper makes the case that the restricted relevance of the ‘conventional framework’ has contributed to the inconsistent and varied provision of care in this setting, and to the knock-on detrimental impact on children nearing the end of their lives as well as their families. We explore the challenges faced by those seeking to conduct economic evaluations in this setting alongside some potential solutions. We conclude that there is no magic bullet approach that will amalgamate the ‘conventional framework’ with the requirements of a meaningful economic evaluation in this setting. However, this does not imply a lack of need for the summation of the costs and outcomes of care able to inform decision makers, and that methods such as impact inventory analysis may facilitate increased flexibility in economic evaluations.
format	article
author	Sebastian Hinde Helen Weatherly Gabriella Walker Lorna K. Fraser
author_facet	Sebastian Hinde Helen Weatherly Gabriella Walker Lorna K. Fraser
author_sort	Sebastian Hinde
title	What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?
title_short	What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?
title_full	What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?
title_fullStr	What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?
title_full_unstemmed	What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?
title_sort	what does economic evaluation mean in the context of children at the end of their life?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d50e6ebad4a347039e09fc46edb2534b
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What Does Economic Evaluation Mean in the Context of Children at the End of Their Life?

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