SAGE Journals

Reinforce chapter themes with free access to two journal articles for each chapter and further online readings. Select chapters will also include suggested weblinks.

Journal Article 16.1: Goldhaber-Fiebert, J. D. and Brandeau, M. L. (2015) ‘Evaluating cost-effectiveness of interventions that affect fertility and childbearing: How health effects are measured matters’, Medical Decision Making 35(7): 818–46.

Discussion Points: How is economic evaluation defined in this context? Critically evaluate the paper.

Journal Article 16.2: Wales, K., Salkeld, G., Clemson, L., et al. (2018) ‘A trial based economic evaluation of occupational therapy discharge planning for older adults: The HOME randomized trial’, Clinical Rehabilitation 32(7): 919–29.

Discussion Points: Outline the meaning of ‘economic evaluation’ in this context? Assess the value of this paper.

Journal Article 16.3: Sonswell, C., Smith, A. C., Scuffham, P. A. and Whitty, J.A. (2016) 'Economic evaluation strategies in telehealth: Obtaining a more holistic valuation of telehealth interventions', Journal of Telemedicine and Telecare 23(9): 792–6.

Description: Telehealth is an emerging area of medical research. Its translation from conception, to research and into practice requires tailored research and economic evaluation methods. Due to their nature telehealth interventions exhibit a number of extra-clinical benefits that are relevant when valuing their costs and outcomes. By incorporating methods to measure societal values such as patient preference and willingness-to-pay, a more holistic value can be placed on the extra-clinical outcomes associated with telehealth and evaluations can represent new interventions more effectively. Cost-benefit analysis is a method by which relevant costs and outcomes in telehealth can be succinctly valued and compared. When health economic methods are conducted using holistic approaches such as cost-benefit analysis they can facilitate the translation of telehealth research into policy and practice.

Journal Article 16.4: Xu, X-M., Vestesson, E., Paley, L., et al. (2017) ‘The economic burden of stroke care in England, Wales and Northern Ireland: Using a national stroke register to estimate and report patient-level health economic outcomes in stroke’, European Stroke Journal 3(1): 82–91.

Description: Stroke registries are used in many settings to measure stroke treatment and outcomes, but rarely include data on health economic outcomes. We aimed to extend the Sentinel Stroke National Audit Programme registry of England, Wales and Northern Ireland to derive and report patient-level estimates of the cost of stroke care. An individual patient simulation model was built to estimate health and social care costs at one and five years after stroke, and the cost-benefits of thrombolysis and early supported discharge. Costs were stratified according to age, sex, stroke type (ischaemic or primary intracerebral haemorrhage) and stroke severity. The results were illustrated using data on all patients with stroke included in Sentinel Stroke National Audit Programme from April 2015 to March 2016 (n = 84,184). The total cost of health and social care for patients with acute stroke each year in England, Wales and Northern Ireland was £3.60 billion in the first five years after admission (mean per patient cost: £46,039). There was fivefold variation in the magnitude of costs between patients, ranging from £19,101 to £107,336. Costs increased with older age, increasing stroke severity and intracerebral hemorrhage stroke. Increasing the proportion of eligible patients receiving thrombolysis or early supported discharge was estimated to save health and social care costs by five years after stroke. The cost of stroke care is large and varies widely between patients. Increasing the proportion of eligible patients receiving thrombolysis or early supported discharge could contribute to reducing the financial burden of stroke. Extending stroke registers to report individualised data on costs may enhance their potential to support quality improvement and research.