Cost-effectiveness in healthcare: a comprehensive review on economic evaluations and methodological variations addressing chronic non-traumatic upper extremity pain
OA Version
Citation
Abstract
OBJECTIVE: The demand for the effective and quality delivery of medical services continues to grow considerably creating a strain on the finite resources available for healthcare. As a result, the integration of economic evaluations within the healthcare sector is becoming more valuable as a tool for deciphering the value of clinical interventions. Analyzing the associated costs and outcomes for alternative healthcare interventions can reveal the relative effectiveness of these interventions in treating prevalent health conditions. Notably, chronic musculoskeletal pain, particularly painful non-traumatic upper extremity conditions (PNUC), afflicts an appreciable amount of individuals in society. The presented thesis proposes the usefulness of a cost-effectiveness analysis (CEA) in providing insight for the practical implementation of interventional treatment in attenuating chronic upper extremity pain.
METHODS: Within healthcare, a CEA is most relevant due to the expression of outcome measurements in natural units pertaining to mortality and morbidity. Recognizing the central facets of a CEA will help researchers conceptualize the pragmatic application of this instrument. A brief review of the existing literature informed the relevance and structural tailoring of a CEA in healthcare specifically. Highlighting key methods and measures for potential translation in an ongoing Mass General Hospital (MGH) Center for Health Outcomes and interdisciplinary Research (CHOIR) study was accomplished.
RESULTS: Key components of a structured CEA were chosen such as the Incremental Cost-Effectiveness Ratio that relates the costs and outcomes of relative interventions statistically. Particular methods address the varying type of costs and their associated outcomes were suggested such as the adoption of a Human Capital and Quality-adjusted life year approach, respectively. Next, the validity of measurements for these methods were considered and subsequently suggested such as the utilization of published cost databases and survey questionnaires.
DISCUSSION: The next steps for economic evaluations include designing solutions to enhance the quality of methodological variations for increased comparability. Applying an economic evaluation at MGH CHOIR to address the effectiveness of a mind-body intervention will reveal the extent to which the quality of life for patients with PNUC has been altered. Future directions include extending this evaluation to a broader range of varying healthcare conditions to further investigate the beneficiary nature of varing interventional treatments. Fostering the implementation of cost evaluations in hospitals will maximize healthcare expenditure and further bridge the gap in creating effective long-term care.
Description
2024
License
Attribution 4.0 International