ORIGINAL ARTICLE

Trends in paediatric health economic evaluation: 1980 to 1999

W J Ungar^1,2, M T Santos¹

¹ Department of Population Health Sciences, The Hospital for Sick Children, Toronto, Canada
² Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

Correspondence to:
Correspondence to:
Dr W Ungar
Scientist, Population Health Sciences, Hospital for Sick Children Research Institute, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8; wendy.ungar{at}sickkids.ca

Background: Although standard methods for conducting economic evaluations have evolved, little attention has been paid to their application in paediatrics. The Paediatric Economic Database Evaluation (PEDE) Project was conceived to promote research into paediatric health economic methods.

Aim: To examine trends in paediatric economic evaluation between 1980 and 1999.

Methods: A comprehensive literature database created for the PEDE project was the source of the data. Descriptive statistics were used to summarise trends. Publication volume, study outcome category, analytical technique, and journal type were examined over the study period.

Results: The literature search resulted in 787 full paediatric economic evaluations. The volume of publications increased from 61 to 440 citations per 5 year period. The most common health outcome category was cases of disease/condition/abnormality. Cost-effectiveness analysis (CEA) was the most common technique used, accounting for a majority of evaluations in all time periods. The proportion of studies using CEA increased by 23 percentage points, while the proportion using cost–benefit analysis decreased from 31% in 1980–84 to 12% in 1995–99. Cost-utility analysis was the least common analytical technique. Publication in journals of paediatrics/perinatal medicine was the most common venue for all intervals and increased as a proportion of the total over time.

Conclusions: The growth in publication of paediatric economic evaluations suggests that increasing attention should be paid to the application of health economic methods to a paediatric population to ensure high quality allocation decisions.

Keywords: economic evaluation; publication; paediatrics; trends

Abbreviations: CBA, cost–benefit analysis; CEA, cost-effectiveness analysis; CMA, cost-minimisation analysis; CUA, cost-utility analysis; QALY, quality adjusted life year

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