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The health-related quality of life (HrQoL) and the recovery process of persons with mental health conditions can be assessed with the Recovering Quality of Life questionnaires (ReQoL-20 and ReQoL-10). The aim of this study was to assess the psychometric properties of the German version of the ReQoL measures in patients with anxiety, obsessive-compulsive, stress-related, and somatoform disorders and in patients with disorders of adult personality and behavior. This study was based on a sub-sample of patients that were included in a randomized controlled trial evaluating an evidence-based, stepped and coordinated care service model for mental disorders (RECOVER). The internal consistency was assessed using Cronbach's Alpha and the test-retest reliability was assessed by the intra-class correlation coefficient (ICC). Concurrent validity was assessed by Pearson's Correlation Coefficient and the known-group validity was assessed using the Cohen's d. The internal consistency of the ReQoL-20 and ReQoL-10 was excellent and good with Cronbach's alpha of α = 0.91 and α = 0.83 for all items. The test-retest reliability of the ReQoL measures was moderate with ICC of r = 0.72 to 0.74. The concurrent validity of the ReQoL measures with the Global Severity Index was overall high with a correlation coefficient of r = -0.70. In conclusion, for patients with anxiety, obsessive-compulsive, stress-related, somatoform and personality disorders, the German version of the ReQoL measures is valid and reliable for the assessment of HrQoL and the recovery process.

Zusammenfassung Zielsetzung Bisher konnte der Ressourcenverbrauch bei einem Kontakt mit dem Justizsektor in gesundheitsökonomischen Evaluationen aus gesellschaftlicher Perspektive nicht monetär bewertet werden. Methodik Es wurden 12 Kostensätze (KS) zur Messung des Ressourcenverbrauchs basierend auf Definitionen des PECUNIA-Projekts ermittelt. KS wurden mittels Literatur- und Internetrecherche, direkter Korrespondenz mit Kostenträgern oder Proxys erhoben. Ergebnisse Es wurden KS für Polizei, Feuerwehr, Vandalismus, Gefängnisaufenthalt, Polizeigewahrsam, einfachen und schweren Diebstahl, geringfügigen und schweren Vandalismus an Immobilien und Anwaltskosten vor Gericht kalkuliert. Schlussfolgerung Bisher fehlten KS für den Justizsektor, die für ökonomische Evaluationen aus gesellschaftlicher Perspektive erforderlich sind. Die Nutzbarkeit der KS in Forschungsfeldern außerhalb der Gesundheitsökonomie betont die Relevanz dieser Arbeit. Schlüsselwörter Intersektorale Kosten, Bewertungssätze, ökonomische Evaluation, psychische Erkrankungen, Kostenkalkulation Calculation of Standardized Unit Costs of Mental Health in the Criminal Justice Sector – Results of the PECUNIA Project for Germany

Background The generic self-reported Recovering Quality of Life (ReQoL) measures were developed for measuring recovery-focused health-related quality of life (HrQoL) in persons with mental health conditions. The aim of this study was to assess the psychometric properties of the German version of the ReQoL measures in patients with affective disorders in Germany. Methods Data from a patient sub-sample in a randomized controlled trial have been used (N = 393). The internal consistency and the test–retest reliability of the ReQoL measures were assessed using Cronbach’s Alpha and the intra-class correlation coefficient (ICC). The concurrent validity and the known-group validity of the ReQoL measures were assessed using Pearson’s Correlation coefficient and Cohen’s d. The responsiveness was assessed using Glass' Δ and the standardized response mean (SRM). Results The reliability among the items of the ReQoL-20 was overall excellent. The ICC of the ReQoL-20 was r = 0.70, indicating moderate test–retest reliability. The concurrent validity of the ReQoL-20 with the clinical measure PHQ-9 was strong with a correlation coefficient of r = − 0.76. The known-group validity of the ReQoL-20 using PHQ-9 cut-off points was large with an effect size of d = 1.63. The ReQoL measures were sensitive to treatment response and remission of symptoms measured by the PHQ-9 with large effect sizes/SRM. Discussion The psychometric properties of the ReQoL measures for the assessment of patients with affective disorders were overall good. With the ReQoL, valid and reliable measures for the assessment of recovery-focused HrQoL for persons with affective disorders are available in German language.

ZusammenfassungDieser Beitrag gibt einen Überblick über die mit Übergewicht und Adipositas assoziierten Kosten in Deutschland und stellt empirische Ergebnisse zur Kosteneffektivität von Maßnahmen zur Regulierung von TV-Werbung für ungesunde Lebensmittel aus der internationalen Literatur vor. Übergewicht und Adipositas gehen mit sehr hohen Kosten für das Gesundheitssystem und die Gesellschaft einher, welche zugleich das maximale Einsparpotenzial an theoretisch vermeidbarer ökonomischer Krankheitslast darstellen. Am Beispiel der Regulierung von TV-Werbung für ungesunde Lebensmittel wird aufgezeigt, wie mit den Methoden der ökonomischen Evaluation die Kosteneffektivität von Präventionsmaßnahmen beurteilt werden kann. Eine internationale Literatursuche identifizierte sechs modellbasierte Kosteneffektivitätsanalysen, die die Wirtschaftlichkeit von Regulierungen für Zeithorizonte zwischen 10 und 100 Jahren untersuchen. Die Interventionen erwiesen sich in allen Studien und für alle untersuchten Länder/Populationen als kosteneffektiv oder kostensparend. Zukünftig sollten vermehrt Interventionsprogramme, bestehend aus aufeinander abgestimmten und simultan implementierten präventiven und therapeutischen Maßnahmen entwickelt und ökonomisch evaluiert werden.

Hintergrund und Stand (inter)nationaler Forschung: Für ältere Menschen mit Pflegebedürftigkeit, die zu Hause gepflegt werden, besteht das Risiko einer Verschlechterung der Mundgesundheit. Mit zunehmender Gebrechlichkeit und nachlassender Mobilität verringert sich die Zahl der Zahnarztbesuche. [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Aim Health economic evaluations conducted from a societal perspective currently do not consider inter-sectoral unit costs (UC) of the German Criminal Justice Sector.Methods UCwere calculated according to the pre-defined measurement parameters from the PECUNIA questionnaire by means of literature and internet research, or direct correspondence with the institution. If UC could not be identified, proxies were used.Results UC were calculated for police, fire brigade, vandalism, prison, police custody, simple and serious theft, minor and serious vandalism of real estate, and legal fees in court.Conclusion The lack of UC for services in the criminal justice sector in Germany makes this work important for health economic evaluations from a societal perspective. The usability of the developed UC outside of health economics, such as forensic psychiatry, emphasizes the relevance of this work.

International audience; OBJECTIVES: Patients waking up with stroke symptoms are often excluded from intravenous thrombolysis with alteplase (IV-tpa). The WAKE-UP trial, a European multicenter randomized controlled trial, proved the clinical effectiveness of magnetic resonance imaging-guided IV-tpa for these patients. This analysis aimed to assess the cost-effectiveness of the intervention compared to placebo. METHODS: A Markov model was designed to analyze the cost-effectiveness over a 25-year time horizon. The model consisted of an inpatient acute care phase and a rest-of-life phase. Health states were defined by the modified Rankin Scale (mRS). Initial transition probabilities to mRS scores were based on WAKE-UP data and health state utilities on literature search. Costs were based on data from the University Medical Center Hamburg-Eppendorf, literature, and expert opinion. Incremental costs and effects over the patients' lifetime were estimated. The analysis was conducted from a formal German healthcare perspective. Univariate and probabilistic sensitivity analyses were performed. RESULTS: Treatment with IV-tpa resulted in cost savings of €51 009 and 1.30 incremental gains in quality-adjusted life-years at a 5% discount rate. Univariate sensitivity analysis revealed incremental cost-effectiveness ratio being sensitive to the relative risk of favorable outcome on mRS for placebo patients after stroke, the costs of long-term care for patients with mRS 4, and patient age at initial stroke event. In all cases, IV-tpa remained cost-effective. Probabilistic sensitivity analysis proved IV-tpa cost-effective in \textgreater95% of the simulations results. CONCLUSIONS: Magnetic resonance imaging-guided IV-tpa compared to placebo is cost-effective in patients with ischemic stroke with unknown time of onset.

Measuring objective resource-use quantities is important for generating valid cost estimates in economic evaluations. In the absence of acknowledged guidelines, measurement methods are often chosen based on practicality rather than methodological evidence. Furthermore, few resource-use measurement (RUM) instruments focus on the measurement of resource use in multiple societal sectors and their development process is rarely described. Thorn and colleagues proposed a stepwise approach to the development of RUM instruments, which has been used for developing cost questionnaires for specific trials. However, it remains unclear how this approach can be translated into practice and whether it is applicable to the development of generic self-reported RUM instruments and instruments measuring resource use in multiple sectors. This study provides a detailed description of the practical application of this stepwise approach to the development of a multi-sectoral RUM instrument developed within the ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) project.For the development of the PECUNIA RUM, the methodological approach was based on best practice guidelines. The process included six steps, including the definition of the instrument attributes, identification of cost-driving elements in each sector, review of methodological literature and development of a harmonized cross-sectorial approach, development of questionnaire modules and their subsequent harmonization.The selected development approach was, overall, applicable to the development of the PECUNIA RUM. However, due to the complexity of the development of a multi-sectoral RUM instrument, additional steps such as establishing a uniform methodological basis, harmonization of questionnaire modules and involvement of a broader range of stakeholders (healthcare professionals, sector-specific experts, health economists) were needed.This is the first study that transparently describes the development process of a generic multi-sectoral RUM instrument in health economics and provides insights into the methodological aspects and overall validity of its development process.