Economic Evaluation in Child Health: Challenges, Costs, and Consequences

The costs of health care continue to rise, and it is therefore more important than ever before to make wise investment decisions. HPME faculty member Wendy Ungar has recently edited and published the first textbook in English to focus on the application of health economic evaluation to child health. In addition to its value for researchers, this collection will assist decision-makers faced with determining how best to use evidence to allocate health-care resources.

An expert in the application of health economic methods to children, Ungar has gathered together leading figures in the discipline to address this diverse topic. Economic Evaluation in Child Health (Oxford University Press, 2009) surveys the main challenges in measuring health-related costs and consequences in children.

A fairly standard set of methods governs how the costs of health care resource use are measured and weighed against improvements in health. Ungar comments, however, that “applying those methods to children raises myriad challenges. And attempting to capture the full spectrum of costs and health consequences over a child’s lifetime can be difficult.”

Difficulties arise, for example, from having to rely on a parent to report on a child’s health or on health questionnaires that have been designed for adults. Further, according to Ungar, “addressing child health means considering costs not only within the health system, but also in schools, communities, and households.”

In addition to several chapters devoted to specific methodological issues, Ungar’s book reviews economic evidence in common childhood conditions, including newborn screening, abuse prevention, mental health services, brain injury, asthma, and immunization. A number of the contributors explore the special problem of improving child health in developing countries. The final section scrutinizes issues pertaining to using child health economic evidence in decision-making.