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BMC Public Health

, 15:954

First Online: 24 September 2015Received: 13 October 2014Accepted: 07 September 2015DOI: 10.1186-s12889-015-2247-7

Cite this article as: van Mastrigt, G.A., Paulus, A.T., Aarts, MJ. et al. BMC Public Health 2015 15: 954. doi:10.1186-s12889-015-2247-7


BackgroundPublic health interventions can impact a broad number of outcomes, including both health and non-health outcomes NHOs. However, although it is often acknowledged that it’s important to take NHOs into account in economic evaluation studies, in practice these are often neglected. To address this issue, our study investigated expert views regarding the incorporation of NHOs into the economic evaluations of public health interventions, by means of a qualitative study.

MethodsA purposive sampling method was used to recruit the experts in the field of health economics and-or public health for this study. Twenty-two semi-structured interviews were held. After recording, the interviews were transcribed verbatim and entered in Nvivo. The data was analyzed using a thematic analysis to identify all important themes mentioned by the experts. Data collection and analysis was continued until saturation was reached. Multiple coding and validity checks were performed to further strengthen the rigour of our methodology.

ResultsBased on the expert interviews, the following overarching themes were identified; Theme 1: NHOs on the individual level, direct social level and societal level. Theme 2: Pros and Cons regarding the development of a new instrument to measure NHOs. Theme 3: The most important requirements for a new questionnaire to be developed for measuring broader outcomes. Theme 4: Alternative methods which could be used for measuring and valuating NHOs in economic evaluations for public health.

DiscussionOur research findings indicate that the importance of NHOs and the need to measure them are universally accepted. Most of the experts acknowledge the importance of measuring broader outcomes and support the development of a new instrument to measure these. The experts, who do not support the development of a new instrument, question its usefulness and feasibility; i.e., they are not sure whether it is possible to valuate NHOs. Furthermore, experts have strong and sometimes conflicting views on the specific requirements of a new instrument to be developed for measuring NHOs. They did not identify a single preferred alternative method for measurement and valuation.

ConclusionsMost experts find a wide range of NHOs important and are in favor of developing a new instrument for identifying and measuring NHOs. Hence, an open discussion needs to be initiated with experts and other stakeholders about which steps need to be taken to move forward.

KeywordsNon-health outcomes Economic evaluation Expert views Public health interventions Patient-reported outcomes measurements Qualitative research AbbreviationsNHOsNon-health outcomes

EEEconomic evaluations

PHPublic Health

CEACost-effectiveness analyses

CUACost-utility analyses

CCACost-consequence analysis

QALYsQuality-adjusted life years

CBACost benefit analysis

MCDAMulti-criteria decision analyses


IQIntelligent Quotient

GHQGeneral Health Questionnaire

SWLSSatisfaction With Life Scale

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Author: Ghislaine APG van Mastrigt - Aggie TG Paulus - Marie-Jeanne Aarts - Silvia MAA Evers - Adrienne FG Alayli-Goebbels

Source: https://link.springer.com/

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