Methods for health economic evaluation of complex interventions in
                    healthcare: current practice, challenges and guidance for future
                    research

Nadja Chernyak; Damon Mohebbi; Adrienne Alayli; Johann Behrens; Helene Eckhardt; Cornelia Henschke; Rolf Holle; Nadja Kairies-Schwarz; Sebastian Liersch; Ralph Möhler; Dirk Müller; Anja Neumann; Markus Vomhof; Ingrid Zechmeister-Koss; Juliane Köberlein-Neu; Andrea Icks

doi:10.1055/a-2569-9765

Das Gesundheitswesen, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Gesundheitswesen
DOI: 10.1055/a-2569-9765

Original Article

Methoden zur gesundheitsökonomischen Evaluation komplexer Interventionen in der Gesundheitsversorgung: aktuelle Praxis, Herausforderungen und Weiterentwicklungsbedarf

Artikel in mehreren Sprachen: English | deutsch

Autor*innen

Nadja Chernyak

¹Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

²Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

³German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
Damon Mohebbi

¹Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

²Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Adrienne Alayli

⁴Institute of Health Economics and Clinical Epidemiology, University of Cologne, University Hospital of Cologne, Cologne, Germany

⁵Clinic of General Pediatrics, Neonatology and Pediatric Cardiology, Heinrich-Heine-University, University Hospital of Düsseldorf, Düsseldorf, Germany
Johann Behrens

⁶Institute of Health and Nursing Science, Martin Luther University of Halle-Wittenberg, Halle, Germany
Helene Eckhardt

⁷Department of Health Care Management, Faculty Economics and Management, Technische Universität Berlin, Berlin, Germany
Cornelia Henschke

⁸Department of Health Care Management, Berlin Center for Health Economics Research, Technische Universität Berlin, Berlin, Germany
Rolf Holle

⁹Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
Nadja Kairies-Schwarz

¹Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Sebastian Liersch

¹⁰AOK North East, Potsdam, Germany
Ralph Möhler

¹Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Dirk Müller

⁴Institute of Health Economics and Clinical Epidemiology, University of Cologne, University Hospital of Cologne, Cologne, Germany
Anja Neumann

¹¹Institute of Health Services Management and Research in the School of Economics and Business Administration, University of Duisburg-Essen, Essen, Germany
Markus Vomhof

¹Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

²Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

³German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
Ingrid Zechmeister-Koss

¹²Austrian Institute of Health Technology Assessment, Wien, Austria
Juliane Köberlein-Neu

¹³BUW Competence Centre for Health Management and Public Health, Faculty of Management and Economics, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
Andrea Icks

¹Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

²Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

³German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany

Abstract

Zusammenfassung

Gesundheitsökonomische Methoden können die Entwicklung und Evaluation von neuen Versorgungskonzepten unterstützen, indem sie Daten zu eingesetzten Ressourcen genieren und diese ins Verhältnis zu einem definierten Nutzen setzen. Die meist angewendete Standardmethodik der gesundheitsökonomischen Evaluation wird dabei jedoch dem hohen Komplexitätsgrad von Interventionen in der Gesundheitsversorgung nicht gerecht. Dadurch fehlen entscheidungsrelevante Informationen, beispielsweise zu Präferenzen der Zielgruppe, zu Spillover-Effekten auf Seiten pflegender Angehöriger, oder zu Implementierungskosten und der Rolle unterschiedlicher Kontexte bei der Überführung von Interventionen in die Regelversorgung. Das Standard setzende Rahmenwerk des britischen Medical Research Councils (MRC) für komplexe Interventionen betont daher die Notwendigkeit, gesundheitsökonomische Aspekte stärker in alle Phasen der Entwicklung und Evaluation komplexer versorgungsbezogener Interventionen einzubeziehen. Um dies zu ermöglichen müssen die Empfehlungen des MRC zur Erweiterung und Anpassung der Standardmethodik der gesundheitsökonomischen Evaluation konkretisiert und ergänzt werden. Aufbauend auf bereits etablierten methodischen Verfahren sollen hierzu Empfehlungen entwickelt sowie Vorschläge für erforderliche weitere Forschung formuliert werden.

Schlüsselwörter

Gesundheitsökonomische Evaluation - Komplexe Interventionen - MRC Framework

Volltext

Referenzen

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