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Health outcomes and economic evaluation

Health economics may be defined as the application of economic theories and methods on health and health care.

Health and its value is one sub area of health economics that includes perceived attributes of health, value of life, health state index, and utility scaling. Another sub area concerns what influences health and a third is about economic evaluation.

The Health Outcomes and Economic Evaluation Research Group performs methodological and applied research using patient-reported outcome measures (PROMs) with focus on measurement and valuation of health, determinants for health and inequalities in health. The research group belongs to Stockholm Centre for Healthcare Ethics (CHE) at the department; health economics and ethics are linked, especially valuation of health and priority setting in health care.

The EQ-5D is used in several projects carried out within the research group. The generic EQ-5D instrument is a PROM applicable to a wide range of health conditions and treatments and can be used in clinical settings, as a health care performance indicator, in economic evaluation and in measurement of population health in surveys. It provides a simple descriptive profile, a health state, and a health state index.

An EQ-5D health state may be converted to an index value by applying a formula that essentially attaches values to each of the levels in each dimension of health. A value set can be obtained using different methods for the valuation of health states, e.g. the time trade-off (TTO) method and the visual analogue scale (VAS) method. A central question is whether valuations should be based on preferences from individuals who are actually in the health state, i.e. experience-based values, or from individuals to whom the health states are described, i.e. hypothetical values. The index value can be used to estimate the quality-of-life component in quality-adjusted life years (QALYs). The EQ-5D for adults as and the EQ-5D-Y for youth are applied in studies.

We have ongoing collaboration with Stockholm County Council and carry out research commissioned by the Health Services Administration (Hälso- och sjukvårdsförvaltningen, HSF) to the Centre for health economics, informatics and health care research (CHIS), see this web page in Swedish.

Research Group

The group is lead by Kristina Burström (PhD) who is associate professor of health economics. Other members in the group include Mimmi Åström (MSc/MPH), PhD candidate; Shaofan Chen (MSc), Chinese Scholarship Council PhD awardee; Fitsum Teni (MSc/MPH), doctoral student, Sonja Krig (RN, MSc/MPH), research assistant, Haiting Jiang, visiting PhD candidate from Nanjing Medical University, China, Ola Rolfsson (MD, PhD) associate professor at the University of Gothenburg, Sahlgrenska Academy, Department of Orthopaedics, and the Swedish Hip Arthroplasty Register; Peter Lindgren (PhD), professor of health economics and research director at the Swedish Institute for Health Economics (IHE); Sophie Langenskiöld (PhD), senior lecturer at Uppsala University, Department of Medical Sciences; Jenny Berg (PhD), Dental and Pharmaceutical Benefit Agency (TLV); Jonas Lundkvist (PhD), associate professor of health economics. The research group collaborates with the Equity and Health Policy research group at the Department of Public Health Sciences.

Jenny BergAnknuten
Kristina BurströmForskare
Shaofan ChenAnknuten
Haiting JiangAnknuten
Sonja KrigAnknuten
Erik LandfeldtAnknuten
Sophie LangenskiöldAnknuten
Peter LindgrenProfessor, adjungerad
Jonas LundkvistAnknuten
Ola RolfsonAnknuten
Fitsum TeniForskningsassistent
Mimmi ÅströmAnknuten

Research group leader

Forskare

Kristina Burström

Enhet: CHE/Hälsomått och ekonomisk utvärdering
E-post: Kristina.Burstrom@ki.se

Collaborative partners

Several of the research group members are members in the international multidisciplinary research group, the EuroQol Group Association and members of the Youth Special Interest Group and the Inequalities Special Interest Group.

Jiaying Chen, Professor, Nanjing Medical University, China

Xuanxuan Wang, PhD, Nanjing Medical University, China

Sun Sun, PhD, researcher, Department of Public Health and Clinical Medicine, Umeå University

Ongoing Projects

Measurement and valuation of health states in adults

Measurement and valuation of health states in youths

Analyses of EQ-5D data across patient groups in the National Quality Registers

Application of EQ-5D-3L value sets in different patient groups

Studies using generic and condition-specific health-related quality of life instruments in patient groups

Population health

Development of the EQ-5D-Y-5L

EQ-5D-Y-5L in psychiatric inpatient care for children and adolescents

Inequalities in health and health in disadvantaged groups

Use of PROMs and PREMs in the evaluation of the Chinese health care reform

Education

The course Health Outcomes Measurement within the Master’s Programme in Health Economics, Policy and Management is a responsibility of the research group. We also supervise master students’ thesis work.

Selected Publications

23975375

21042861

Development of the EQ-5D-Y: a child-friendly version of the EQ-5D
Wille N, Badia X, Bonsel G, Burström K, Cavrini G, Devlin N, Egmar AC, et al
Qual Life Res. 2010 Aug;19(6):875-86

Health-related quality of life 10 years after intracranial aneurysm rupture: a retrospective cohort study using EQ-5D
von Vogelsang AC, Burström K, Wengström Y, Svensson M, Forsberg C
Neurosurgery. 2013 Mar;72(3):397-405

19370697

20850576

Outcome-free design of observational studies: peer influence on smoking.
Langenskiöld S, Rubin D
Annales d'économie et de statistique (Annals of Economics and Statistics). 2008;91/92:107-125

Financing (external funders)

  • Health Services Administration (HSF), Stockholm County Council
  • EuroQol Research Foundation
  • FORTE (Swedish Research Council for Health, Working Life and Welfare)
  • ALF-2019
  • National Natural Chinese Foundation of China
  • Chinese Scholarship Council