Health Economics and Health Technology Assessment (HEHTA)

Economics of Population Health

Program Lead  Emma McIntosh

GoWell

GoWell is a collaborative partnership between the Glasgow Centre for Population Health (GCPH), the University of Glasgow, and the MRC/CSO Social and Public Health Sciences Unit, sponsored by Glasgow Housing Association, the Scottish Government, NHS Health Scotland and NHS Greater Glasgow and Clyde. GoWell is a research and learning programme that aims to investigate the impact of investment in housing, regeneration and neighbourhood renewal on the health and wellbeing of individuals, families and communities over a ten-year period.  The programme aims to establish the nature and extent of these impacts, to learn about the relative effectiveness of different approaches, and to inform policy and practice in Scotland and beyond. An economic evaluation of GoWell costs and outcomes is ongoing.

HEHTA Contact person: Kenny Lawson

THRIVE

Trial of Healthy Relationship Initiatives for the Very Early-years (THRIVE). THRIVE is a Three-Arm Randomised Control Trial for Mothers Identified as Vulnerable in Pregnancy and their Babies who are at High Risk of Maltreatment. Applied economic evaluations in the area of home visiting and parenting, many of which have been conducted in the have suffered from diverse economic objectives and methodological problems including the lack of a societal perspective and limited cost analysis. THRIVE trial will include a comprehensive economic evaluation which will assess the costs and outcomes associated with the delivery of each intervention and treatment as usual from the NHS and personal social services perspective favoured by NICE. A broader societal perspective will also be adopted to allow for the possibility of costs and outcomes beyond the NHS and PSS such as housing, education, employment and justice. The cost-effectiveness will be assessed by comparing the additional costs associated with each of the interventions to the outcomes achieved in the study and those achievable in the longer term.

HEHTA Contacts: Emma McIntosh & Kathleen Boyd

SEED

Social and Emotional Education and Development (SEED). SEED is a Stratified, Cluster Randomised Trial of a Multi-component Primary School Intervention that follows the Pupils‟ Transition into Secondary School. SEED is based on the Seattle Social Development Project and the Gatehouse Project, with potential incorporation of Growing Confidence. A key component of SEED is the economic evaluation which will be integral to the main trial. Estimates of cost and utility will be collected for each trial arm and compared within an incremental cost-utility analysis framework.

HEHTA Contact person:  Elisabeth Fenwick

Evaluation of the New Orleans Intervention Model for Infant Mental Health in Glasgow (BeST)

Funded by the CSO and NSPCC this study investigates the New Orleans Intervention Model (NIM) for maltreated children in the Scottish context.  The NIM provides intensive assessment and treatment for families of maltreated preschool children in foster care, with recommendations to court about adoption, or permanent return to birth families.  An economic model will be built and populated with data from the trial to assess cost-effectiveness using the ITSEA measure of child mental health. The aim of the economics component is to explore whether the NIM is likely to be cost-effective in Glasgow and, if so, what design parameters are required for the definitive Phase III trial.

HEHTA contact person: Dr Kathleen Boyd

Woods in and around Towns (WIAT)

Funded by the NIHR-PHP, Woods in and around Town (WIAT) aims to answer the research question: How effective is Scotland’s Forestry Commission woodland improvement programme at improving psychological wellbeing in deprived communities. In this project, three ‘active’ intervention sites for the Forestry Commission Scotland’s woodland intervention programme will be matched with three control sites.  The communities adjacent to all six areas will be sampled to assess the potential impact of the intervention programme on wellbeing.  HEHTA will conduct the economic analysis of the programme.

 
HEHTA contact: Andrew Briggs

Dental Population Health Projects

Childsmile is a national programme designed to improve the oral health of children in Scotland and reduce inequalities both in dental health and access to dental services. Childsmile is currently being evaluated by researchers at the University of Glasgow Dental School. HEHTA are working with the Dental school on evaluating the costs of the Childsmile Nursery and School programme and consequently estimating the economic impact of reducing the cost of caries in Scottish schoolchildren. HEHTA are also working with the Dental School on developing health economics within dentistry more generally.

HEHTA Contact person:  Emma McIntosh

HEHTA also has two PhD students working on population health projects in the area of ‘Value of empowerment in an urban regeneration setting’ (Camilla Baba: funded by the Glasgow Centre for Population health) and another exploring the lifetime costs and effects of self-management of diabetes in Ethiopia (Tadesse Gebrye). Some of the key methodological challenges faced in the economic evaluation of population health interventions include lack of randomised study designs and use of natural experiments as well as the identification, measurement and valuation of multisectoral cost and effect impacts.

In May 2012 HEHTA hosted a PHSRN funded workshop entitled ‘Methods for the economic evaluation of population health interventions: conceptual and practical challenges’. The report from this workshop is available to download from the following link:

PHSRN funded Workshop 3rd & 4th May 2012.

Ongoing collaborations through his workshop have been developed and the aim is to have a follow up workshop in 2013.