Views, obstacles, and uncertainties around the inclusion of children and young people's time in economic evaluations: Findings from an international survey of health economists

Lazaros Andronis; Cameron Morgan; Cam Donaldson; Emily Lancsar; Stavros Petrou

doi:10.1016/j.socscimed.2023.116179

Views, obstacles, and uncertainties around the inclusion of children and young people's time in economic evaluations: Findings from an international survey of health economists

Soc Sci Med. 2023 Sep:333:116179. doi: 10.1016/j.socscimed.2023.116179. Epub 2023 Aug 16.

Authors

Lazaros Andronis¹, Cameron Morgan², Cam Donaldson³, Emily Lancsar⁴, Stavros Petrou⁵

Affiliations

¹ Centre for Health Economics at Warwick, Warwick Medical School, University of Warwick, Coventry, UK. Electronic address: l.andronis@warwick.ac.uk.
² Centre for Health Economics at Warwick, Warwick Medical School, University of Warwick, Coventry, UK.
³ Yunus Centre for Social Business & Health, Glasgow Caledonian University, Glasgow, UK; Department of Health Services Research and Policy, Australian National University, Canberra, Australia.
⁴ Department of Health Services Research and Policy, Australian National University, Canberra, Australia.
⁵ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

PMID: 37611459
DOI: 10.1016/j.socscimed.2023.116179

Abstract

People's time is a limited resource and, in economic evaluations that adopt a societal perspective, it is important that it is valued and accounted for. Yet, in economic evaluations of interventions for children and young people (CYP), attempts to take into account the opportunity cost of their time are rare. To understand why this is the case, we need to first understand what views health economists hold in relation to CYP time, and what challenges they face in incorporating this in their evaluations. We planned and carried out an international survey of health economists. We used a combination of approaches to identify potential survey respondents (the survey's sampling frame), we developed a questionnaire that sought to capture respondents' views and practice through close- and open-ended questions, we piloted the questionnaire through a series of cognitive interviews, and we e-mailed unique links to the final version of the questionnaire to 1956 individuals in the sampling frame. We analysed data using quantitative (descriptive and inferential statistics) and qualitative (thematic analysis) methods. We received 274 complete responses. Most respondents (87%) believe CYP time should be considered for inclusion in economic evaluations conducted from a societal perspective. However, they identify a number of obstacles to doing so, most prominently uncertainties around appropriate practice (e.g., when CYP's time should or should not be included in calculations), methodological gaps (e.g., what value to attach to CYP's time), and practical difficulties in measuring displaced time in CYP. Reporting on their own practice, most respondents found it challenging to consider CYP time in their studies, and stressed the need for clear guidance on when, and further research on how, to appropriately account for CYP's time in economic evaluations. We offer our views on how to move the topic forwards and make suggestions further research.

Keywords: Children and young people; Economic evaluation; International online survey; Value of time.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Cost-Benefit Analysis*
Humans
Uncertainty