Applying discrete social experiments in social care research

Discrete choice experiments (DCEs) have been widely used by economists to elicit people’s values in a number of areas, including market, transport and environmental issues. The last two decades have seen an increasing use of the technique in health economics, and it is beginning to be applied in social care and related research. This review aims to help social care researchers, policymakers and practitioners make the best use of DCEs to value preferences in social care settings. It discusses what DCE is, what you can do with it, and its use to incorporate informal care in economic evaluations. It also describes the key stages of developing a DCE for social care and presents a comprehensive search of the literature to identify and describe DCE applications to social care. Some of the important challenges of applying DCEs to social care are identified, and the need for further methodological development is discussed

What, who and when? Incorporating a discrete choice experiment into an economic evaluation

Acknowledgements The Medman study was funded by the Department of Health for England and Wales and managed by a collaboration of the National Pharmaceutical Association, the Royal Pharmaceutical Society of Great Britain, the Company Chemist Association and the Co-operative Pharmacy Technical Panel, led by the Pharmaceutical Services Negotiating Committee. The research in this paper was undertaken while the lead author MT was undertaking a doctoral research fellowship jointly funded by the Economic and Social Research Council (ESRC) and the Medical Research Council (MRC). The Health Economics Research Unit (HERU), University of Aberdeen is funded by the Chief Scientific Office of the Scottish Government Health and Social Care Directorate.Peer reviewedPublisher PD

Implementing the Directive on patients’ rights in cross-border healthcare: are we ready?

On Friday 25 October 2013 European Union countries will bring into force their regulations necessary to comply with the Directive on patients’ rights in cross-border healthcare. On the same day at LSE, policymakers will join academics from the 13 partner institutions in the European Union Cross Border Care Collaboration (EUCBCC) project to discuss international experiences (for more information about the event or to book a place please see here)

Implementing shared-decision-making for diabetes care across country settings: what really matters to people?

Diabetes is one of the leading causes of mortality, disability and expenditure worldwide. Growing evidence of improved outcomes (patient/professional satisfaction and some evidence on controlled weight, blood glucose and blood pressure) supports shared-decision-making (SDM) as an effective primary care intervention for diabetes. However, only a few countries have actually adopted it (e.g. UK). In other European countries there is awareness that patients play a crucial role in decision-making, and SDM policies could be considered as innovative strategies to promote the actual implementation of patient rights legislation and strengthen primary care (e.g. Cyprus). Objective of this research was to inform the development and testing of a tool to value patients’ preferences for SDM model across different European settings: UK, where SDM is already in place at a national level, and we can draw from people direct experience; Cyprus, where people are new to it, although there could be room for future implementation. In doing so the study used a discrete-choice-experiment (DCE) survey. The DCE survey presents a series of choices involving alternative services on offer, described by their particular characteristics. It allows to: identify the characteristics of the health care service that respondents value; the relative values that they attach to these; and the trade-offs between them (e.g. how long patients are willing to wait to receive detailed and accurate information about their care). Data collection is under way and findings will be available for discussion at the meeting. They will inform the development of a larger European programme of research

VP164 Applying health technology assessment to pharmacy: the Italian-Medicine-Use-Review-Health Technology Assessment

There is a lack of Health-Technology-Assessment (HTA) tools in pharmacy practice and the collection of real-world-evidence (RWE) in community pharmacy to populate longer-term-disease-progression-modelling (1). This project is looking at the development and application of a novel Patient-Reported-Outcome- Measure (PROM) in community pharmacy that can enable: the evaluation of the quality of care delivered from the patient perspective in terms of economic impact, patient health outcomes and ‘utilities’; the collection of RWE and evaluate long-term effect of care; to provide different stakeholders with unique evidence-based information that help formulate health policies in community pharmacy that are safe, effective, patient-focused and cost-effective, balancing access to innovation and cost containment. Evidence from the Italian-Medicine-Use-Review (I-MUR) trial (2) showed that the I-MUR intervention provided by community pharmacists to asthma patients is effective, cost-saving and cost-effective (3). The trial allowed to model a framework (I-MUR-HTA) that would enable to routinely deliver the intervention, but also collect and analyse PROM data on its clinical-effectiveness, quality-of-life and cost-effectiveness. I-MUR-HTA was discussed within three expert-panel discussions including policy-makers, commissioners, academics, healthcare-professionals and patient-representatives in Italy, United Kingdom and Europe. Current plan include testing the use of the tool in the real world environment. Evidence collected from the panel discussions confirmed that I-MUR-HTA evidence-based information is relevant to meet current National-Health-Care-System plans and this is what is needed to support the evaluation of innovative effective and cost-effective health policies and promote their implementation across nations. Current Italian law on pharmacy services provides the appropriate institutional framework to regulate the introduction of I-MUR-HTA across the territory. Its implementation is underway and a real-world pilot is planned to take place in Italy. I-MUR-HTA appears to be an innovative tool to promote active patient involvement into policy-decision-making and pharmacy-service

Making the economic case for adult social care: the EconomicS of Social carE CompEndium (ESSENCE) project

Constrained social care resources mean that decision-makers must make difficult choices about how to allocate them to best effect. The EconomicS of Social carE CompEndium (ESSENCE) project aims to collate and build economic evidence on adult social care (including both cost and outcome data) and make it available to decision-makers, managers, practitioners and individuals who use or pay for services themselves. Searches for economic evidence were undertaken across a range of databases. The ESSENCE toolkit offers a comprehensive collection of relevant research and summarises it with individual case summaries and a searchable database. Seventeen case summaries and a database with 231 sources have been produced to date, published on the project website. Evidence is grouped into service categories, focussing primarily on interventions considered core to adult social care for which there are studies considered to be robust in terms of design, quality, consistency and setting. The toolkit also provides signposts to interventions where it is currently not possible to examine the economic case but which could be evaluated in future research