Journal of Preventive Medicine and Public Health

Special Article

The Primary Process and Key Concepts of Economic Evaluation in Healthcare: Younhee Kim, Yunjung Kim, Hyeon-Jeong Lee, Seulki Lee, Sun-Young Park, Sung-Hee Oh, Suhyun Jang, Taejin Lee, Jeonghoon Ahn, Sangjin Shin; J Prev Med Public Health. 2022;55(5):415-423. Published online August 24, 2022; DOI: https://doi.org/10.3961/jpmph.22.195

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Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

Summary

Korean summary
보건의료분야에서 경제성 평가는 의약품과 진단검사 및 치료법 등 의료기술에 대한 평가에서 널리 활용되고 있다. 본 연구에서는 경제성 평가절차를 경제성 평가 설계, 결과 산출, 비용산출, 모형 구축 및 분석, 비용-효과성 결과 제시 및 불확실성 평가와 의사 결정 단계로 나누어 주요 개념과 쟁점들을 소개하였다.

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Outbreak of carbapenem-resistant Enterobacterales at a long-term care facility in Seoul, Korea: surveillance and intervention mitigation strategies
Yoojin Park, Euncheol Son, Young June Choe, Cho Ryok Kang, Sangmi Roh, Young Ok Hwang, Sung-il Cho, Jihwan Bang
Epidemiology and Health.2023; 45: e2023057. CrossRef

Original Articles

Health-related Quality of Life Instrument With 8 Items for Use in Patients With Type 2 Diabetes Mellitus: A Validation Study in Korea: Juyoung Kim, Hyeon-Jeong Lee, Min-Woo Jo; J Prev Med Public Health. 2022;55(3):234-242. Published online May 12, 2022; DOI: https://doi.org/10.3961/jpmph.22.020

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Abstract Summary PDF Supplementary Material

Objectives
This study assessed the validity and reliability of the Health-related Quality of Life Instrument with 8 Items (HINT-8) in patients with diabetes. HINT-8 is a newly-developed, generic health-related quality of life (HRQoL) instrument.
Methods
Three HRQoL instruments—HINT-8, EuroQoL 5-Dimension 5-Level (EQ-5D-5L), and Short Form Health Survey version 2.0 (SF-36v2)—were provided to 300 patients with diabetes visiting a tertiary hospital for follow-up visits in Korea. The HRQoL scores obtained using the HINT-8 were evaluated for subgroups with known differences based on demographics and diabetes-related characteristics (known-group validity). The mean scores of the instruments were compared between groups segmented by their responses to the HINT-8 (discriminatory ability). Correlation coefficients of the HINT-8 with other instruments were calculated (convergent and divergent validity). The Cohen kappa and intra-class correlation coefficient (ICC) were also evaluated (test-retest reliability).
Results
The average HINT-8 indexes were lower among women, older, and less-educated subjects. Subjects who did not list any problems on the HINT-8 had significantly higher HRQoL scores than those who did. The correlation coefficients of the HINT-8 with the EQ-5D-5L index and EuroQoL visual analogue scale were 0.715 (p<0.001) and 0.517 (p<0.001), respectively. The correlation coefficients between the HINT-8 index and the scores of 8 domains of the SF-36v2 ranged from 0.478 (p<0.001) to 0.669 (p<0.001). The Cohen kappa values for the HINT-8 ranged from 0.268 to 0.601, and the ICC of the HINT-8 index was 0.800 (95% confidence interval [CI], 0.720 to 0.860).
Conclusions
This study showed that the HINT-8 is a valid and reliable HRQoL instrument for patients with diabetes.

Summary

Korean summary
이 연구는 한국인의 사회문화적 특성을 반영하여 개발된 건강관련 삶의 질 도구인 HINT-8의 타당도 및 신뢰도를 대표적인 만성 질환인 제2형 당뇨 환자를 대상으로 검증하였다. 연구결과는 제2형 당뇨 환자에서 HINT-8의 활용 가능성을 보여주었을 뿐만 아니라 일반적 건강관련 삶의 질 도구 중 가장 널리 사용되고 있는 EQ-5D-5L보다 HINT-8이 삶의 질 상태를 더욱 정교하게 구분하고 있음을 보여주었다.

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Chiwook Chung, Ah-Ram Kim, Dongbum Kim, Hee Kwon, Seong Ho Lee, Il-Young Jang, Min-Woo Jo, Do-Yoon Kang, Sei Won Lee
Scientific Reports.2024;[Epub] CrossRef
Chronic Disease Patterns and Their Relationship With Health-Related Quality of Life in South Korean Older Adults With the 2021 Korean National Health and Nutrition Examination Survey: Latent Class Analysis
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Internal Structure of the Health-Related Quality of Life Instrument with 8-Items in a Nationally Representative Population
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Journal of Korean Academy of Nursing.2023; 53(3): 359. CrossRef
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BMJ Open.2023; 13(9): e072698. CrossRef

Development and Validation of a Novel Generic Health-related Quality of Life Instrument With 20 Items (HINT-20): Min-Woo Jo, Hyeon-Jeong Lee, Soo Young Kim, Seon-Ha Kim, Hyejung Chang, Jeonghoon Ahn, Minsu Ock; J Prev Med Public Health. 2017;50(1):38-59. Published online January 10, 2017; DOI: https://doi.org/10.3961/jpmph.16.081

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Abstract PDF Supplementary Material

Objectives
Few attempts have been made to develop a generic health-related quality of life (HRQoL) instrument and to examine its validity and reliability in Korea. We aimed to do this in our present study.
Methods
After a literature review of existing generic HRQoL instruments, a focus group discussion, in-depth interviews, and expert consultations, we selected 30 tentative items for a new HRQoL measure. These items were evaluated by assessing their ceiling effects, difficulty, and redundancy in the first survey. To validate the HRQoL instrument that was developed, known-groups validity and convergent/discriminant validity were evaluated and its test-retest reliability was examined in the second survey.
Results
Of the 30 items originally assessed for the HRQoL instrument, four were excluded due to high ceiling effects and six were removed due to redundancy. We ultimately developed a HRQoL instrument with a reduced number of 20 items, known as the Health-related Quality of Life Instrument with 20 items (HINT-20), incorporating physical, mental, social, and positive health dimensions. The results of the HINT-20 for known-groups validity were poorer in women, the elderly, and those with a low income. For convergent/discriminant validity, the correlation coefficients of items (except vitality) in the physical health dimension with the physical component summary of the Short Form 36 version 2 (SF-36v2) were generally higher than the correlations of those items with the mental component summary of the SF-36v2, and vice versa. Regarding test-retest reliability, the intraclass correlation coefficient of the total HINT-20 score was 0.813 (p<0.001).
Conclusions
A novel generic HRQoL instrument, the HINT-20, was developed for the Korean general population and showed acceptable validity and reliability.

Summary

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Natalia Hernández-Segura, Alba Marcos-Delgado, Arrate Pinto-Carral, Tania Fernández-Villa, Antonio J. Molina
International Journal of Environmental Research and Public Health.2022; 19(24): 16493. CrossRef
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Kaley Butten, Peter A. Newcombe, Anne B. Chang, Jeanie K. Sheffield, Kerry-Ann F. O’Grady, Newell W. Johnson, Neil King, Maree Toombs
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Journal of Korean Medical Science.2021;[Epub] CrossRef
Validity and reliability of the Health-Related Quality of Life Instrument with 8 Items (HINT-8) in Korean breast cancer patients
Juyoung Kim, Min-Woo Jo, Hyeon-Jeong Lee, Sei-Hyun Ahn, Byung Ho Son, Jong Won Lee, Sae Byul Lee
Osong Public Health and Research Perspectives.2021; 12(4): 254. CrossRef
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Julian Thumboo, Mandy Y. L. Ow, Elenore Judy B. Uy, Xiaohui Xin, Zi Ying Clarice Chan, Sharon C. Sung, Dianne Carrol Bautista, Yin Bun Cheung, Xiang Li
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