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Arthritis Patient Education: How Economic Evaluations Can Inform Health Policy

Published online by Cambridge University Press:  08 November 2023

Ann E. Clarke*
Affiliation:
Montreal General Hospital
*
Requests for reprints should be sent to:/Les demandes de reproduction doivent être adressées à: Ann E. Clarke, Divisions of Clinical Epidemiology and Clinical Immunology/Allergy, Montreal General Hospital, 1650 Cedar Avenue, Montreal, PQ H3G 1A4
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Abstract

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As Canadian health policy-makers struggle to contain costs while maintaining quality, patient education is promoted as making patients more effective producers of health and consumers of health care. Assessment of existing psychoeducational interventions has concentrated on knowledge enhancement, behaviour modification, and health status while economic outcomes have remained unexplored. Given that such programs are likely to be effective, but costly, economic appraisals are necessary to convince cost-conscious policy-makers. This manuscript describes a cost-effectiveness evaluation of the Arthritis Self-Management Program (ASMP) that I and my collaborators are conducting by randomizing participants to the ASMP as an adjunct to usual medical care versus usual medical care. Direct and indirect costs are evaluated through self-reporting of health services utilization and diminished productivity and effectiveness through a visual analogue scale and the SF-36. To influence health policy, the results must be disseminated to public health authorities, private insurers, and patient and health professional organizations, thereby encouraging funding, increasing awareness, and promoting participation.

Résumé

Résumé

Dans le cadre de la lutte des responsables de l'élaboration des politiques de santé pour endiguer les coûts tout en maintenant la qualité, on promouvoit l'éducation des patients comme moyen d'amélioration de la santé et de recours plus dosé aux soins de santé. L'évaluation des interventions psychopedagogiques en place s'est concentrée sur 1'amélioration des connaissances, la modification du comportement et l'état de santé mais les résultats économiques n'ont pas été explorés. Étant donné que ces programmes pourraient étre efficaces mais coûteux, il est essentiel d'en faire I'evaluation économique pour mieux convaincre les responsables de l'élaboration des politiques pour qui les coûts constituent un élément important. Ce document présente une évaluation du Arthritis Self-Management Program (ASMP) que j'effectue avec mes collaborateurs en randomisant les participants qui ont ajouté l'ASMP aux soins habituels par comparaison a l'utilisation stricte des soins de santé habituels. Les coûts directs et indirects sont vérifiés par auto-évaluation de l'utilisation des services de santé ainsi qu'en fonction d'une diminution de la productivité et l'efficacité est établie par une échelle analogue visuelle et le SF-36. Les résultats obtenus, si Ton souhaite qu'ils influencent les politiques de santé, doivent être diffusés aux services de santé publique, aux assureurs privés, aux patients et aux organismes professionnels de santé, ce qui a pour effet de favoriser le financement, d'augmenter la sensibilisation et de promouvoir la participation.

Type
Research Article
Copyright
Copyright © Canadian Association on Gerontology 1997

Footnotes

*

The author wishes to thank the Principal Investigator in this SIRP-funded study, Patrick McGowan, PhD, Research Associate, Institute of Health Promotion and Research, University of British Columbia, for helpful discussions as well as Steven Grover, MD, MPH and Hanna Zowall, MA of the Division of Clinical Epidemiology, Montreal General Hospital for assistance in developing the costing methodology. This work is supported by the Seniors' Independence Research Program (SIRP) of the National Health Research and Development Program.

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