Feasibility study to address key condition/risk factor cost evidence gaps
Feasibility study to address key condition/risk factor cost evidence gaps
Theme 4: Applied Evaluation
There are evidence gaps regarding the societal costs of key health conditions and risk factors that reduce the ability of policy makers to efficiently allocate constrained resources. These include a lack of comparable public and private costs (in particular, health care resources, social care resources, productivity and informal care costs) and associated fiscal impacts (including the tax and welfare transfers) across key health conditions and risk factors.
Published societal costs for a given health condition/risk factor can sometimes vary significantly due to, for instance, different methods and missing and/or different cost categories (e.g. social care costs) and sub-cost categories (e.g. absenteeism). Similarly, cost categories and methods often vary across health conditions and risk factors, which means that cost estimates are generally not comparable across health conditions/risk factors.
Costs feed into models that determine the economic efficiency of interventions. The lack of comparable costs means that the evidence used to prioritise resources across public health/health interventions may not give a fair/accurate picture, so we may not be prioritising effectively. Policy makers may end up implicitly comparing costs when modelling the economic returns on an intervention to decide whether it is worth investing in, or using existing internal tools that collate health condition/risk factor costs, even if appropriate caveats are in place, which could lead to incorrect conclusions.This makes it hard to understand where to prioritise resources across preventing different conditions/risk factors.
It is recognised that there does not exist a single data source that would allow simultaneous causal estimation of the attributable economic impacts with ability to decompose to consistently defined and measured disease, risk factor, geography and sociodemographic characteristics. Hence the purpose of this feasibility study is to understand the extent to which the desired information could be produced by combining data or estimates from multiple sources. It is also of interest to understand the practicality and costs of different methods for producing and updating this information. This research will aim to aid the prioritisation of resources across public health and health interventions that seek to prevent key risk factors and health conditions in England.
This project aims to address evidence gaps in relation to the generation of consistent cost estimates across diseases and risk factors by:
i) Summarising the current approaches to estimating comparable cost estimation for societal (in particular, health care, social care and productivity) costs of key health conditions and risk factors.
ii) Considering how comparable costs could be estimated in a way such that the costs could be updated in an automated fashion, as far as possible.
iii) Summarising how comparability can be defined and assessed and determining methods that could be used to assess the risk and consequences of misprioritisation.
iv) Summarising potential methodological work to evaluate the quality and any potential trade-offs across different approaches to cost estimation (e.g. lower quality but more frequent update based on routine data vs higher quality bespoke estimation with less frequent update)
Susan Griffin - susan.griffin@york.ac.uk