Costing Health Economic Evaluation Project (CHEEP)
Key objective
In 2007, CHERE was awarded the Costing for Health and Economic Evaluation Program, a program of research jointly funded by NSW Health and the Cancer Institute NSW. The objectives of the Program were to provide evidence regarding the cost and consequences of health interventions, services and systems that is useful to NSW Health and the Cancer Institute NSW, develop a model for defining and producing policy relevant deliverables for these stakeholders, develop and report new methods for studying, and knowledge regarding, the costs and consequences of health interventions, services and systems in the course of its work for the stakeholders and build skills and capacity for undertaking these types of analyses in New South Wales. CHEEP represented a new model for funding a program of research within Australia, with the annual work plan and specific projects being developed through a process of negotiation between the funders, CHERE and the Sax Institute.
The following projects were auspiced under the CHEEP program of work. CHEEP is now complete.
NSW Health projects
1. Good for Kids
CHERE staff
Marion Haas, Richard Norman
The objective of the CHEEP aspect of this project was to work collaboratively with the parties involved in the program, including NSW Health, Hunter New England AHS and the NSW Centre for Overweight and Obesity (COO) to:
• Provide advice on the feasibility of undertaking an economic evaluation of the Good for Kids program
• Estimate the costs of the overall Good for Kids program and individual aspects of the program, as appropriate.
The outputs of the CHEEP Good for Kids project are:
• Input to a detailed process evaluation of the Good for Kids program. The report of this evaluation is an internal document for use by NSW Health and the program itself.
• The development of a framework for reporting the costs of the program. CHERE staff liaised with program staff to ensure they understood and were able to complete such reports on a regular basis; we continue to be available in a support role.
• Production of a report: Issues in Costing aimed at informing managers and staff associated with large public health programs about identifying, measuring and valuing resource use. The report has been produced by NSW Health and widely distributed to Public Health and Health Promotion Units within NSW.
• A presentation to the Advisory Committee of the Good for Kids Program.
2. The Sydney Diabetes Prevention Project
CHERE staff
Marion Haas
The objective of the CHEEP aspect of this project is to evaluate the costs, outputs and outcomes of the project. The project is being piloted in three Divisions of General Practice within Sydney South West AHS. Marion Haas is a member of the Advisory Committee and the Evaluation Management Group for the project, attending monthly meetings since its inception. In collaboration with the evaluation team, she has devised a framework for collecting information about resource use from the perspectives of NSW Health, the Divisions of GP and the research participants. She has also advised on the collection of appropriate outcome measures for the purposes of economic evaluation. The outputs of the CHEEP SDPP are:
• The enrolment of a PhD student (University of Sydney); the thesis will be based on the evaluation of the SDPP and an important component will be the economic analysis of the project. Marion Haas is the co-supervisor of the student.
• The submission of two NHMRC applications for further funding in 2010 aimed at continuing the follow-up of participants in the SDPP; a Partnerships application and a project grant application. Marion Haas is a CI on both applications.
• A publication describing the project methods, accepted for publication in BMC Public Health in June 2010.
Although CHEEP is complete, this project is ongoing. Marion Haas continues to be involved in the evaluation of this and related projects.
3. Economic evaluation of Falls Prevention strategies
CHERE staff
Stephen Goodall, Jody Church, Marion Haas
The objectives of this project are to evaluate the cost-effectiveness of strategies designed to prevent falls amongst NSW residents who are either i) community living adults aged 65 and over or ii) adult residents of aged care facilities. The strategies or interventions to be evaluated (seven aimed at community living adults and four at residents aged care facilities) have been agreed on in consultation with an expert Advisory Committee. Evidence of effectiveness has been taken from recent Cochrane reviews or recently published RCTs. A societal perspective has been used to estimate the costs of each strategy or intervention. Due to the number of strategies and the variation in the amount and strength of evidence available, this is a challenging project. It is likely to be unique in that, within each target group, it will compare the costs and consequences of each strategy or intervention with each of the others.
The outputs of this project are:
• The development of a number of decision analytic models to evaluate the costs and consequences of a range of strategies aimed at preventing falls in the target groups listed above.
• A CHERE seminar has been delivered
• A report will be prepared for NSW Health
• One or more peer-reviewed manuscripts will be prepared.
From the CHEEP perspective, this project is complete.
4. Threshold of investment in overweight and obesity prevention programs targeting children
CHERE staff
Marion Haas, Rosalie Viney
The aims of this project were to assess i) the level of investment in childhood obesity prevention at an Area Health Service (AHS) level and ii) the resources that would be required to maximise the reach of the current childhood obesity prevention program. The level of current investment was measured as the inputs to projects implemented by the South Eastern Sydney Illawarra Health Promotion Service (HPS). Inputs were measured by identifying the activities associated with each obesity prevention project and measuring and valuing the resources used to undertake these activities. The HPS estimated that a 10 year cycle of projects would enable them to reach 100% of children attending organised childcare, primary and secondary schools.
The outputs of this project are:
• A report prepared for NSW Health
• A presentation to the NSW Directors of Health Promotion (September 2008)
• A presentation to the Sax Institute Policy Roundtable (November 2008)
• An abstract submitted to the 2009 conference of the Public Health Association of Australia.
Cancer Institute NSW projects
1. Lung Cancer Costs of Care
CHERE staff
Patsy Kenny, Jane Hall, Marion Haas
A protocol for this project was developed in 2007 and work commenced on a literature review. However, CHERE was advised by the Cancer Institute NSW not to proceed with the project.
2. Costs of Non Melanoma Skin Cancer
CHERE staff
Jane Hall, Marion Haas, Patsy Kenny
The aims of this project are difficult to specify as there is no clear policy issue to investigate. Non-melanoma skin cancer (NMSC) was identified as a priority for CHEEP by the Cancer Council in 2008. CHERE developed a briefing paper as a basis for discussions to determine whether further research on the costs of NMSC is feasible and warranted. It was agreed that CHERE should use data from the 45 and Up Study to further consider issues of cost of NMSC The final report is based on these data and the published literature. The 45 and Up Study Medicare data were not used as arrangements were not yet in place for external researchers to access these data.
The outputs of the project to date are:
• A briefing paper Costs of Non-Melanoma Skin Cancer submitted to the Cancer Institute.
• A final report
From the CHEEP perspective, this project is now completed
Funding Source
NSW Health and NSW Cancer Institute (administered by the Sax Institute)
