Mapping the 12-item World Health Organization disability assessment schedule 2.0 (WHODAS 2.0) onto the assessment of quality of life (AQoL)-4D utilities.

PURPOSE: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a widely used disability-specific outcome measure. This study develops mapping algorithms to estimate Assessment of Quality of Life (AQoL)-4D utilities based on the WHODAS 2.0 responses to facilitate economic evaluation. METHODS: The study sample comprises people with disability or long-term conditions (n = 3376) from the 2007 Australian National Survey of Mental Health and Wellbeing. Traditional regression techniques (i.e., Ordinary Least Square regression, Robust MM regression, Generalised Linear Model and Betamix Regression) and machine learning techniques (i.e., Lasso regression, Boosted regression, Supported vector regression) were used. Five-fold internal cross-validation was performed. Model performance was assessed using a series of goodness-of-fit measures. RESULTS: The robust MM estimator produced the preferred mapping algorithm for the overall sample with the smallest mean absolute error in cross-validation (MAE = 0.1325). Different methods performed differently for different disability subgroups, with the subgroup with profound or severe restrictions having the highest MAE across all methods and models. CONCLUSION: The developed mapping algorithm enables cost-utility analyses of interventions for people with disability where the WHODAS 2.0 has been collected. Mapping algorithms developed from different methods should be considered in sensitivity analyses in economic evaluations.

Social interventions to support people with disability: A systematic review of economic evaluation studies.

Social interventions are essential in supporting the health and well-being of people with disability, but there is a critical need to prioritise resources for those that provide the best value for money. Economic evaluation is a widely used tool to assist priority setting when resources are scarce. However, the scope and consistency of economic evaluation evidence for disability social services are unclear, making it hard to compare across interventions to guide funding decisions. This systematic review aims to summarise the current evidence in the economic evaluation of social services for people with disability and to critically compare the methodologies used in conducting the economic evaluations with a focus on the outcomes and costs. We searched seven databases for relevant studies published from January 2005 to October 2021. Data were extracted on study characteristics such as costs, outcomes, perspectives, time horizons and intervention types. Overall, economic evaluation evidence of social services for people with disability was scarce. Twenty-four economic evaluations were included, with the majority conducting a cost-effectiveness analysis (n = 16). Most interventions focused on employment (n = 10), followed by community support and independent living (n = 6). Around 40% of the studies addressed people with mental illnesses (n = 10). The evidence was mixed on whether the interventions were cost-effective but the methods used were highly variable, which made comparisons across studies very difficult. More economic evidence on the value of interventions is needed as well as a more standardised and transparent approach for future research.

Did the Integrated Urban and Rural Resident Basic Medical Insurance Improve Benefit Equity in China?

OBJECTIVES: The reform of merging 2 major health insurance schemes into Urban and Rural Resident Basic Medical Insurance (URRBMI) is recognized as a vital step to safeguard equal healthcare and benefit to each enrollee in China. Against this backdrop, this article aims to evaluate the impact of URRBMI integration on benefit and its contribution to benefit equity. METHODS: The data of this study were derived from the China Health and Retirement Longitudinal Study 2011 and 2015. A total of 11 383 individuals were included in the final sample. Coarsened exact matching with difference-in-difference approach was firstly adopted to investigate the treatment effects of URRBMI on benefits. Next, the decomposition of concentration index (CI) was conducted to explore the contribution of URRBMI to benefit equity. RESULTS: The coarsened exact matching with difference-in-difference results revealed that the consolidation of URRBMI has significantly improved outpatient benefit. The decomposition results showed that the contribution rates of URRBMI scheme to outpatient benefit rate (CI -0.0114), benefit probability (CI 0.0673), compensation fee (CI 0.0076), and reimbursement ratio (CI 0.0483) were 11.26%, -3.38%, -7.67%, and -0.81%, suggesting that this reform makes contribution to the propoor inequity in the outpatient benefit rate and relieves the prorich inequity in outpatient benefit probability and the degree of benefits. CONCLUSIONS: The findings of this study provide novel evidence of enhanced benefits and benefit equity for outpatient care with the integration of URRBMI. Further efforts should be made to the expansion of URRBMI coverage and the elimination of income disparities that affecting benefit equity.

Factors associated with future intentions to use personal vaporisers among those with some experience of vaping.

INTRODUCTION AND AIMS: Personal vaporisers (PV), including e-cigarettes, may be a harm reduction strategy for tobacco control. This study aims to identify factors associated with future intentions to vape among smokers and ex-smokers in Australia and the UK. DESIGN AND METHODS: Cross-sectional data of smokers and ex-smokers (n = 1199, mean age = 45.3 years, 44.8% male), collected in 2014/2015 and divided into four subgroups: smoking past vapers (SPV), smoking vapers (SV), ex-smoking past vapers (ESPV) and ex-smoking vapers (ESV), from the International Tobacco Control Australia and UK surveys were analysed by using regression models. RESULTS: Higher vaping satisfaction increased vaping intentions for all groups except ESPV. Perceiving PVs as less harmful predicted intentions to vape for all groups except ESV. The importance of PVs for stopping smoking predicted lower intentions to continue vaping for SV, but higher intentions to initiate vaping for SPV. The importance of PVs for cutting down smoking was a positive predictor only for SPV. Among ex-smokers, importance for maintaining not smoking was a positive predictor for ESPV, but not for ESV. The importance of perceiving vapour being less harmful also depended on vaping status for ex-smokers. The only country interaction was that only in the UK was perceiving PVs as less harmful associated with intention among SPV. DISCUSSION AND CONCLUSION: Factors influencing intentions vary by smoking and/or vaping status, with greater differences between the ex-smoker subgroups. This is consistent with PVs being seen as a way of managing smoking, rather than something that has intrinsic value, for all except the ex-smoking vapers. [Ma BH, Yong H-H, Borland R, McNeill A, Hitchman SC. Factors associated with future intentions to use personal vaporisers among those with some experience of vaping. Drug Alcohol Rev 2017;00:000-000].