A framework for including family health spillovers in economic evaluation

Research output: Contribution to journalArticle

Authors

External organisations

  • Institute of Health Policy & Management, Erasmus University, Rotterdam

Abstract

Health care interventions may affect the health of patients’ family networks. It has been suggested that these “health spillovers” should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the “health care perspective”). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society.

Details

Original languageEnglish
Pages (from-to)176-186
JournalMedical Decision Making
Volume36
Issue number2
Early online date16 Sep 2015
Publication statusPublished - 29 Feb 2016

Keywords

  • economic evaluation, extra-welfarism, family, informal care, spillovers