Foto-Cewek’s Seminar series continued this week with a talk from Stavros Petrou, Professor of Health Economics at Warwick University. His presentation entitled: Methodological issues raised by economic evaluations of perinatal and paediatric interventions, was introduced by Foto-Cewek’s Professor Bertie Squire, the Director of CAHRD.
Professor Petrou began by saying that while his work is based on research from the UK, it is likely transferable to the developing countries more relevant to his current audience. He first explained what was unique about perinatal and childhood contexts and how they would be distinguished from other areas of health economic evaluation. These included that perinatal interventions often have disparate effects on mother and child, that a child’s development is marked by rapid changes and that there may be interactive health effects between mother and child. He then went on to look at the context of policy makers’ dilemmas working on the premise that health care and other resources are scarce, that all resources would have alternative uses and that prioritisation is inevitable.
He continued by explaining how health could be evaluated in terms of a cost-utility analysis and how states of health which are less than ‘full health’ can be converted into ‘healthy years’. Quality Adjusted Life Years (QALYs) are used to capture both duration of life and quality of life, incorporating preferences for different health states. One of the problems for carrying out utility measurement in children is that measurements usually focus on adult populations. There are concerns that responses from children may not be accurate given that they might not have the same cognitive or emotional ability to discuss preferences depending on their age, or that they may be influenced by those asking the questions. He illustrated this showing that when parents were asked to respond on behalf of their teenage children to the impact of functional loss, parents often underreport in terms of impacts on emotion, pain, cognition and speech.