Methods of economic evaluation in mental health services: A systematic review with narrative analysis

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Title: Methods of economic evaluation in mental health services: A systematic review with narrative analysis
Author: Leino, Hanna
Contributor: University of Helsinki, Faculty of Social Sciences
Publisher: Helsingin yliopisto
Date: 2021
Language: eng
Thesis level: master's thesis
Degree program: Sosiaali- ja terveystutkimuksen ja -johtamisen maisteriohjelma
Master's Programme in Social- and Health Research and Management
Magisterprogrammet i social- och hälsoforskning och ledning
Specialisation: ei opintosuuntaa
no specialization
ingen studieinriktning
Abstract: There is a common understanding of the benefits of economic evaluations supporting decision making regarding health care interventions. The aim of this master’s thesis was to understand the methods of economic evaluation in mental health services to guide upcoming economic evaluations. The research objective was to investigate and describe key elements and methods that have been used in economic evaluations in mental health interventions for adults. The objective was formed by the following research questions: 1. What methods are used in economic evaluation? 2. What perspectives are considered? 3. How are outcomes measured i.e. what specific measures are used to characterise the outcomes? 4. What cost elements are included in the cost analysis? 5. What cost measures are used? 6. Is there consideration for whether the used method is appropriate to examine the matter concerned? This thesis was conducted as a systematic literature review. The PICo method was used in the formation of the research questions and the search strategy. Two databases (Ovid MEDLINE and PsycINFO) were used. In addition, Google and Google Scholar were used, and reference search from included studies was performed. The methodological quality of the included studies was assessed using the Consensus on Health Economic Criteria checklist. After data extraction and tabulation, narrative analysis was undertaken to summarise and understand the methods and elements for economic evaluation in mental health services. Overall, the quality of the 12 included studies was good. The studies represented different types of populations and interventions in mental health services. Primarily, one intervention was compared to the other, usually against existing care. Cost-effectiveness analysis, cost-utility analysis and cost minimisation analysis were applied. Studies were conducted from societal, health care or health insurance perspectives, and some studies applied two perspectives. Generic and condition-specific patient-reported outcome measures and clinician-reported outcome measures were used alongside routine administrative data to capture change in health status and quality of life. A few different cost measures with routine administrative data were used to identify and measure service resource use and productivity losses. There was variation in what costs were included. Almost all authors stated some consideration about methods suitability, at some level. This master’s thesis collated outcome measures and cost measures utilised in the mental health service context. Moreover, some data sources regarding costs were presented to reveal information sources and demonstrate how chosen perspective determines what information is needed. This master’s thesis provides guidance on what details are needed and where to collect information to conduct an economic evaluation to support decision-making in mental health services.
Subject: Economic evaluation
cost-effectiveness analysis
cost-utility analysis
cost minimisation analysis
cost-benefit analysis
mental health
outcome measure
cost measure

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