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Cost-effectiveness analysis of paediatric mental health interventions: a systematic review of model-based economic
Sanjeewa Kularatna1, Ruvini Hettiarachchi2, Sameera Senanayake1
1Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology (QUT), Brisbane, Australia.
Insights
Model-based economic evaluations for child and youth mental health interventions are increasing. This review found most studies used Markov models or decision trees and had good reporting quality.
Area of Science:
- Health Economics
- Child and Adolescent Psychiatry
- Public Health
Background:
- Child and youth mental health disorders impose a significant burden on healthcare systems.
- Cost-effective interventions are crucial for efficient mental health care allocation.
- Evidence on model-based economic evaluations in child and youth mental health is limited.
Purpose of the Study:
- To systematically review model-based economic evaluations of mental health interventions for children and youth.
Main Methods:
- A systematic search of four databases (MEDLINE, EMBASE, PsycINFO, Web of Science) was conducted.
- Model-based economic evaluations of child and youth mental health interventions were retrieved.
- Reporting quality was assessed using the Consolidated health economic evaluation reporting standards (CHEERS) checklist.
Main Results:
- 1921 records were identified, with 12 studies selected for review; 66% were published after 2015.
- Studies primarily focused on anxiety and post-traumatic stress disorder.
- Common models included Markov models and decision trees, with variations in structure, health states, time horizon, and economic perspective. Reporting quality ranged from 91% to 96%.
Conclusions:
- Model-based economic evaluations in child and youth mental health are becoming more prevalent.
- Markov models and decision trees were frequently employed, individually or combined.
- The majority of reviewed studies demonstrated good reporting quality.
Abstract:
Mental health disorders among children and youth are causing significant burden on health care systems. Hence, identifying cost-effective interventions is important for effective mental health care allocation. Although model-based economic evaluations are an essential component of assessing cost-effectiveness, evidence are limited in the context of child and youth mental health care. The objective was to systematically review the model-based economic evaluations of mental health interventions for children and youth.MethodsFour databases (MEDLINE, EMBASE, PsycINFO and Web of Science) were searched using appropriate search terms to retrieve model-based economic evaluations of mental health interventions for children and youth. The reporting quality of the included studies were appraised using the Consolidated health economic evaluation reporting standards (CHEERS) checklist.ResultsThe database search yielded 1921 records. Of the 12 selected for review, 66% were published after year 2015. Most of the studies were related to anxiety and post-traumatic stress disorder. There were eight cost-utility studies, three cost-effectiveness studies, and one study using both forms of analysis. Six studies used Markov models, three used decision trees, and three studies used both types of models. However, the model structure, health states, time horizon, and economic perspective showed wide variation. The reporting quality of the included studies varied from 91 to 96%.ConclusionModel based mental health economic evaluations among children and youth are increasingly being reported in recent research. The included studies used Markov models and decision trees, either alone or in combination, and the majority of the articles were of good reporting quality.
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