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At least 19 recordsLinked to original sources
PubMed2026

Cost-Effectiveness of Electronic Patient-Reported Outcome Measure Interventions in Cancer: Systematic Review and Parameter Extraction for Economic Modeling.

BACKGROUND: Complex digital interventions that integrate electronic patient-reported outcome measures (ePROM) into clinical practice in cancer have the potential to improve quality of life, increase survival, and reduce health resource use and costs. Such systems can help patients with cancer self-manage chemotherapy symptoms, reduce clinicians' workloads through automated decision support, and resolve problems earlier. However, more research on the cost-effectiveness of ePROM monitoring is needed. OBJECTIVE: This paper comprises two complementary components: (1) a systematic literature review summarizing and evaluating the quantitative and qualitative evidence related to the cost-effectiveness of ePROM monitoring and (2) a health economic model parameter extraction. We also conducted supplementary targeted searches and scoping to provide context to our findings. METHODS: We searched Ovid (including MEDLINE and Embase), Scopus, and the International Health Technology Assessment Database for original English-language papers published on or before March 2025 using search strings that combined terms related to ePROMs, health economics, and cancer/oncology. We included papers reporting health economic-related outcomes for ePROM interventions designed for adult cancer populations and excluded screening tools and conference abstracts. RESULTS: We included 34 publications from 27 unique studies and identified and analyzed 26 ePROM-integrated interventions within these. Most (23/26) of the included interventions explicitly described some form of alert handling and automated decision support based on remote ePROM monitoring. Of the 34 publications, 5 presented full cost-effectiveness analysis results, of which 3 were highly uncertain and lacked clear differences in costs and health outcomes between ePROMs and standard care; conversely, 2 presented strong evidence of cost-effectiveness due to quality-of-life improvements, reduced hospitalizations, and potentially more autonomy in health-related travel (eg, ePROM-monitored patients can drive or walk to the hospital instead of using taxis or ambulances). A further 5 publications reported partial health economic results (eg, cost-consequence and budget impact), of which 1 detected no difference in strategies; in contrast, 4 reported lower health resource use and costs of ePROMs, mainly due to hospitalization reductions. Overall, 12 of the 27 studies included a qualitative component but mostly focused on user experience and design-related themes; only 2 of these addressed economic-specific themes (eg, changes in workflow and resource use due to ePROM implementation and integration), indicating some potential for time saving due to ePROM monitoring. CONCLUSIONS: Some ePROM-integrated interventions demonstrated cost-effectiveness in cancer care, but the evidence base remains limited. Where evidence does exist, cost-effectiveness appears driven by reduced hospitalization and improved quality of life. Qualitative research within the included studies rarely addressed economic questions. We provide a detailed parameter extraction for use in future economic modeling and recommend research priorities, including quantitative mapping of ePROM symptom data onto health resource use patterns, and qualitative work exploring how ePROM implementation affects clinical workloads and patient-perspective costs.

Humans↗
PubMed1989

Factors influencing the consumption of alcohol and tobacco: the use and abuse of economic models.

This paper is concerned with the use of economic models in the debate about the role that tax increases and restrictions on advertising should play in reducing the health problems that arise from the consumption of alcohol and tobacco. It is argued that properly specified demand models that take account of all the important factors that influence consumption are required, otherwise inadequate modelling may lead to misleading estimates of the effects of policy changes. The ability of economics to deal with goods such as alcohol and tobacco that have addictive characteristics receives special attention. Recent advances in economic theory, estimation techniques and statistical testing are discussed, as is the problem of identifying policy recommendations from empirical results.

Alcoholism↗
PubMedDate not supplied

An economic model for nurse manpower planning in the Caribbean--Part 1: The issues.

Below is a noneconomist's view on economic issues impacting on nurse manpower development in the Commonwealth Caribbean. The issues however are of an international nature and are therefore pertinent to all those interested in nurse manpower development. The main objective is to present a model for economic analysis and planning.

Economics, Nursing↗
PubMed1977

[Productive life-span of dairy cows and its economic significance. II. The replacement of dairy cows: an economic model (author's transl)].

A model, initially based on the work of Zeddies (10), is presented , by which the economic aspects of the replacement problem may be studied. First, the principle underlying the replacement decision is discussed. Then, the data to be included in the model are determined. This mainly concerns the elements associated with age, such as milk production, the value of newborn calves, the slaughter of the cows, the feed cost and the cost of a pregnant heifer just before calving. The age-associated probability of culling is also included in the model. A number of questions regarding the economic importance of the duration of herd life have been studied using this model. In the third paper, the results of this application of the model will be presented.

Animal Feed↗
PubMed1991

Work-site health promotion: an economic model.

Despite a burgeoning interest in and acceptance of corporate health promotion, the overall economic effects of these programs are not clear. Although ultimate resolution of this question awaits detailed empiric research, a theoretical approach can be useful in structuring the problem and understanding the critical issues. The financial model presented views the firm as a value-maximizing enterprise and evaluates health promotion as a use of corporate assets. The model projects the benefits and costs to the firm of a 7-year health promotion program under a variety of assumptions regarding the employee mix and the effects of the health promotion program on health and productivity. The analysis reveals that the base case assumptions result in a program that creates value for the firm when the cost is less than $193 per participating employee per year. Firms with a highly productive, difficult to replace, and older employee group are most likely to find health promotion to be a good investment. Productivity gains produce the majority of the economic benefits of the program. Effects on health care expense alone are projected to be relatively small. Gains from reduction in employee mortality or retiree health expense are found to be insignificant in this model.

Absenteeism↗
PubMed1988

Economic modeling of the use of gonadotropin-releasing hormone at insemination to improve fertility in dairy cows.

Economic and sensitivity analysis methods were used to evaluate financial returns from use of gonadotropin-releasing hormone (GnRH) at the time of insemination to enhance fertility of dairy cows. A computer spread sheet was used to determine the best service(s) for GnRH treatment, the increase in conception rate required for economic benefit from treatment, and how profits from GnRH treatment are affected by drug cost, herd reproductive efficiency, and production costs. Financial returns increased from use of GnRH at insemination under most herd conditions. Herds with conception rates less than or equal to 45% benefited from GnRH treatment at any 1 or 2 inseminations. Herds with conception rates greater than or equal to 60% benefited from GnRH treatment only at second or later services. Selection of second and/or third insemination as the GnRH treatment service usually resulted in the greatest total return. The enhancement of fertility necessary to achieve the break-even point with GnRH treatment at third service was 2% for low- and 5% for high-conception-rate herds. Base-line herd conception rates, estrus detection efficiency, replacement costs, value of excess days not pregnant, and cost of treatment had the greatest effect on returns from treatment. Herds with high conception rates and low replacement costs were likely to realize the least benefit from GnRH treatment at insemination. On the basis of our findings, we concluded that GnRH treatment at insemination is a profitable procedure under most herd conditions. Optimal treatment regimens for specific herds may best be determined by using herd performance and management data for calculating returns.

Animals↗
PubMedDate not supplied

An economic model for nurse manpower planning in the Caribbean: Part II--Strategies.

Figure 5 illustrates the key ingredients of manpower planning. Whatever model or framework that have or will be considered for the Region must be based on cost containment necessitated by the scarcity of resources. Since the health sector is labour intensive, health manpower is critical for its successful functioning. Approximately 65-70% of the Ministries of Health's recurrent budget is allocated for health personnel. Budgetary restrictions as a result of economic downturn have therefore impacted severely on the manpower resources resulting in a decreased supply of all categories of health workers in the health service. Even the most minimum level of services is therefore jeopardized. Most countries of the Region are at present suffering from a net loss in most of the health professional groups and some countries are without auxiliary groups. In providing quality care, certain questions need to be answered. In the light of decreasing economic resources and accompanying decreasing nurse manpower resources: 1. What degree of substitutability between categories of health manpower generally and specifically, between different categories of nurses will affect their efficient use and provide quality care? 2. What are the least cost combinations of nurse manpower that will ensure greater productivity and quality care? 3. What are the policy restrictions that may hinder substitutability? 4. What are the market forces that affect the demand and supply of nurses? In all of the above, it is necessary to understand that the basis of any nurse manpower policy and plan and the economic analysis of these is guided by the demand for health care and services as well as economics within a given country.

Economics, Nursing↗
PubMed1990

Dietary energy levels for growing-finishing pigs fed ad libitum. 2. Carcass effects and economic model of the responses.

The NRC (1988) recommendations on nutrient standards for growing-finishing pigs assume a corn-based feeding regime. However, the diets used in Western Canada are generally barley-based and consequently are usually lower in digestible energy (DE) and result in reduced growth rate and feed efficiency. Corn and wheat can be included in the diet to raise the DE level, but since this could affect the carcass quality of pigs fed ad libitum, the influence of DE level in relation to carcass quality was measured in two experiments. An economic assessment of the data was also conducted. A total of 432 pigs was used, over the 20-98 kg live weight range. The inclusion of wheat or corn to barley-based diets during the finisher period resulted in reduced carcass quality, and there was also some evidence that increased dietary energy during the grower stage had the same effect.

Adipose Tissue↗
PubMedDate not supplied

Application of an economic model to the study of leprosy control costs.

The effectiveness of various control methods for reducing the incidence of leprosy have been tested over 20 years and compared with predictions made using the present current control method (early diagnosis and mass treatment). Specific vaccination of the whole population, a control measure yet to be developed, has been identified as the most effective strategy in the long run. A cost-effectiveness analysis has been carried out for three indicators, annual incidence, annual prevalence and cumulative prevalence at 20 years, using cumulative costs. The analysis indicates that specific vaccination at high levels of coverage is the most effective method for controlling incidence in the long term. Provided the cost of the vaccination campaign during the first years (roughly fourfold the funds required for carrying out the current strategy) can be supported, specific vaccination is also the most cost-effective method where a high level of effectiveness is required. Specific vaccination is still the most advantageous method if prevalence or cumulative prevalence are taken to indicate the effectiveness of leprosy control. The BCG-type of vaccination is not only less effective, it is also less cost-effective. Reducing the rate of abandonment of treatment (which in the model has been simulated by increasing the rate of resuming treatment) and earlier detection both appear as useful methods under conditions of severe budgetary constraints. Their ultimate effectiveness in terms of incidence reduction is, however, very small. As expected, segregation is costly and ineffective compared with other methods. In each simulation, the cost of treating the backlog of patients already ill or infected (incubating) at the time the control measures are initiated is high. Methods aimed at reducing transmission, such as vaccination, early treatment or segregation, have long-delayed effects on the cost even if incidence is reduced. The major cost item in these control measures is the prolonged or even life-long treatment of patients. The development of fast-acting, effective treatment is likely to be the only way to reduce the cost in the short term. Thus, in addition to research aimed at developing a vaccine for leprosy, resources should also be allocated for developing new therapeutics.

BCG Vaccine↗
PubMed1992

A family process model of economic hardship and adjustment of early adolescent boys.

We propose a family process model that links economic stress in family life to prosocial and problematic adolescent adjustment. Employing a sample of 205 seventh-grade boys aged 12 to 14 years (M = 12.7) and living in intact families in the rural Midwest, the theoretical constructs in the model were measured using both trained observer and family member reports. In general, results were consistent with the proposed model. Objective economic conditions such as per capita income and unstable work were related to parents' emotional status and behaviors through their perceptions of increased economic pressures such as the inability to pay monthly bills. These pressures were associated with depression and demoralization for both parents, which was related to marital conflict and disruptions in skillful parenting. Disrupted parenting mediated the relations between the earlier steps in the stress process and adolescent adjustment. The emotions and behaviors of both mothers and fathers were almost equally affected by financial difficulties, and disruptions in each parent's child-rearing behaviors had adverse consequences for adolescent development.

Adaptation, Psychological↗
PubMed1992

Econometric critique of the economic change model of mortality.

The application of time-series data and analysis to study the effects of changes in unemployment rates on mortality rates has been a controversial issue in health-unemployment research for many years. This article presents new criticism against previous aggregate time-series regression models and concludes that these models are misspecified in functional form, and the t-ratios used in significance tests are grossly overstated. Future empirical analysis of the Economic Change Model of Mortality, i.e. the aggregate, time-series relationship between mortality rates and economic variables must pay more attention to the salient characteristics of time-series data and implications for regression results.

Bias↗
PubMed1991

Nursing care classification: a conceptual model.

Economic constraints, the information explosion, and advancement of scientific theories have resulted in the need for nurses to document their unique contribution to health care through validation of nursing resources consumed by patients. However, various classification systems have not predicted nursing resources well. This study reviews the theoretical frameworks, reliability, validity, and utility of nursing acuity and severity systems. It proposes a conceptual model for a new nursing classification system to be used for the validation of nursing resources, as the basis of a reimbursement system for nursing services, and for multiple practical and theoretical applications.

Humans↗
PubMed2026

An Application of Iterative Health Economic Evaluation: An Update on the Early Cost Effectiveness of Whole-Genome Sequencing in Advanced Non-small-Cell Lung Cancer.

OBJECTIVE: Whole genome sequencing (WGS) can identify more druggable targets than the standard of care (SoC) panels, however, its health effects and costs are highly uncertain. Given the rapidly evolving treatment landscape and pricing, an iterative approach is crucial to continuously reassess evidence and adapt economic models. Our objective was to update a previously developed economic model for WGS. METHODS: We used a structured approach to identify and report model elements requiring updates, based on established tools and methodological guidance, and applied it to the probabilistic decision model by Simons et al.(2021), which compared SoC, WGS, and SoC followed by WGS in patients with inoperable stage IIIB, C/IV NSCLC in the Dutch setting. RESULTS: Updates included a new treatment (sotorasib), revised drug and diagnostic costs, and adherence to the latest guidelines. Drug and WGS diagnostics costs fell by 8% and 26%, respectively. SoC diagnostic prices increased by 17%. We explored the impact of the prevalence of druggable targets, effectiveness of off-label treatments, (academic-specific) diagnostic costs, and price negotiations. The ICER of WGS versus SoC decreased from €737,197 to €419,053/QALY. WGS would become cost-effective if diagnostic costs descended from €2,180 to €1,246 or if additional druggable targets were identified in ≥3.3% of patients. CONCLUSION: Our structured approach effectively identified items in the original analysis requiring updates and provides a foundation for further developing a checklist to guide iterative HTA. Continued monitoring and assessment of new treatment options, the dynamic diagnostics and costs throughout the life-cycle remain necessary to determine when WGS can be considered cost-effective.

NSCLC↗
PubMed1986

Accident modelling and economic evaluation.

This paper summarizes contributions to the IDBRA workshop made by Votey, Krupp and Jones-Lee. Votey set out the basic principles of costs and benefits as applied to accident control measures and discussed the various elements of effective economic analysis. Krupp presented information relating to the determination of the costs of injury accidents in the Federal Republic of Germany, and Jones-Lee discussed in more general terms the principle ways in which accident costs might be determined. The final section draws some general conclusions relating to the workshop as a whole.

Accidents, Traffic↗