Headline
Evaluating service innovations in health care and public health requires flexibility, collaboration and pragmatism; this collection identifies robust, innovative and mixed methods to inform such evaluations.
There are well-developed guidelines for economic evaluation of clearly defined clinical interventions, but no such guidelines for economic analysis of service interventions. Distinctive challenges for analysis of service interventions include diffuse effects, wider system impacts, and variability in implementation, costs and effects. Cost-effectiveness evidence is as important for service interventions as for clinical interventions. There is also an important role for wider forms of economic analysis to increase our general understanding of context, processes and behaviours in the care system. Methods exist to estimate the cost-effectiveness of service interventions before and after introduction, to measure patient and professional preferences, to reflect the value of resources used by service interventions, and to capture wider system effects, but these are not widely applied. Future priorities for economic analysis should be to produce cost-effectiveness evidence and to increase our understanding of how service interventions affect, and are affected by, the care system.
About the Series
Health Services and Delivery Research
ISSN (Print): 2050-4349
ISSN (Electronic): 2050-4357
Article history
This report is the 9th essay of the HS&DR report “Challenges, solutions and future directions in the evaluation of service innovations in health care and public health” https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr04160/#/abstract. The first version of the report was the output from a meeting in London in June 2015 and the subsequent management of the proceedings funded by The Health Foundation, The Medical Research Council, the National Institute for Health Research and Universities UK. It began editorial review in November 2015 and was accepted for publication in March 2016. The additional chapter is the result of a roundtable meeting in February 2017 funded by the National Institute for Health Research and the Medical Research Council. The authors of the whole report have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors’ report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.
This report presents independent work and the views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health.
Declared competing interests of authors
Matt Sutton reports grants from the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater Manchester and is deputy chairperson of the NIHR Health Services and Delivery Research (HSDR) Board. He is also a NIHR senior investigator. Graham Martin is part funded/supported by the NIHR CLAHRC East Midlands and is a member of the NIHR HSDR Evidence Synthesis Sub Board and the NIHR Health Technology Assessment (HTA) programme National Stakeholder Advisory Group. Stephen Morris is part funded/supported by the NIHR CLAHRC North Thames at Bart’s Health NHS Trust and is a member of the NIHR HSDR Board and the NIHR HSDR Evidence Synthesis Sub Board. Samuel I Watson and Richard J Lilford are both part funded/supported by the NIHR CLAHRC West Midlands. Mark Sculpher is a NIHR emeritus senior investigator and a member of the Medical Research Council Methodology Research Programme Advisory Group. Steph Garfield-Birkbeck is an assistant director at the NIHR Evaluation, Trials and Studies Coordinating Centre at the University of Southampton and is a member of the NIHR HSDR programme and HTA programme secretariats. Rachel Meacock is an associate member of the NIHR HSDR Board. Andrew Street served as a member of the NIHR HSDR board until January 2017.
Disclaimer
This publication is linked to a series of essays published by the National Institute for Health Research Journals Library in 2016 [Raine R, Fitzpatrick R, Barratt H, Bevan G, Black N, Boaden R, et al. Challenges, solutions and future directions in the evaluation of service innovations in health care and public health. Health Serv Deliv Res 2016;4(16)].
Last reviewed: November 2015; Accepted: March 2016.
