Research

The Health Economics and Policy Analysis Centre (HEPAC) seek to develop and encourage the use of economics in the area of health and healthcare. The research focus of HEPAC is directed by four objectives which inform our four methodological themes:

Health Economic Evaluation

Our first objective is to conduct research that informs policy and practice through the generation of evidence on cost effectiveness for health and social care interventions that target individuals, their families and friends across the life course.

Such evidence is generated from the application of economic evaluation methods and is relevant for informing resource allocation decision-making by policy makers and practitioners in health and social care systems. The methodological expertise of HEPAC includes the following:

  • Health Technology Assessment
  • Economic Evaluation based on Randomised Controlled Trials
  • Economic Evaluation based on Decision Analytic Models

Researchers in HEPAC currently apply these methods in a variety of areas in collaboration with clinicians, health and social scientists at NUI Galway and in other Irish, European and US research institutions. HEPAC provide health economics support to the Health Research Board (HRB)-Trials Methodology Research Network (TMRN), the HRB-Primary Care Clinical Trials Network Ireland (CTNI), the HRB-Clinical Research Facility Galway (CRFG) and the Centre for Research in Medical Devices (CURAM). Recent economic evaluations include studies relating to antimicrobial resistance, potentially inappropriate prescribing, dementia, cancer, stroke, dementia, obesity, heart disease, diabetes, gestational diabetes, chronic obstructive pulmonary disorder, refractory asthma, mental health, disability and sexually transmitted disease.

Health Preference Valuation

Our second objective is to conduct research to inform policy and practice through the generation of evidence on health outcomes for individuals, their families and friends across the life course. 

Such evidence is generated from the application of preference-based methods and is relevant in the context of the need to appropriately identify, measure and value of the impact of illness, intervention, or policy on the health and wellbeing of individuals, families and friends, and/or society.

The methodological expertise of HEPAC includes the following:

  • Discrete Choice Experiments
  • Contingent Valuation

Researchers at HEPAC currently apply these methods on a number of projects including a HRB funded study, which is being undertaken in collaboration with and the support of the EUROQoL group, and which entails the development and analysis of a preference valuation set for the EQ-5D-5L health states among the Irish general public. The output from this project will provide a set of preference weights for health in Ireland that can be applied for the future conduct of health economic evaluation and health technology assessment. Other studies in this methodological area include the estimation of public preferences for resource allocation across different types of healthcare programmes, and within the ageing area more specifically.

Health Econometrics

Our third objective is to conduct research to inform policy and practice through the generation of evidence on drivers of health, health behaviour, healthcare utilisation, social and economic outcomes for individuals, their families and friends across the life course. Particular emphasis is placed on the estimation of causal rather than associative effects.

Such evidence is generated from the application of econometric methods and is relevant in the context of the need to identify the factors that impact upon these outcomes, the nature of such impacts, and the implications for health system equity and/or efficiency.

The methodological expertise of HEPAC includes the following:

  • Cross Sectional Techniques
  • Longitudinal Techniques
  • Geographic Information Systems Techniques

Researchers at HEPAC apply microeconometric techniques to explore a wide variety of empirical questions in the field of health economics. This typically involves the practical analysis of quantitative, qualitative and categorical data collected as part of national surveys and linked administrative databases. This involves the formulation of hypotheses, the selection of appropriate econometric methods, the estimation of microeconometric models, and the interpretation of the results in a manner intended to test particular hypotheses or inform the development of particular policy instrument. A common feature of the work conducted in this area has been the exploration of socioeconomic inequalities as they relate to health and health care in Ireland. Recent work published by the group has explored inequalities with respect to the uptake of cancer screening services in Ireland and compared the provision of services in Ireland with those in other jurisdictions. Similarly, using econometric and spatial geographic information systems (GIS) techniques, researchers have published work exploring the impact of travel distance on the uptake of screening for gestational diabetes mellitus. Exploring the determinants and impact of obesity on the island of Ireland represents a growing area of interest within the Group at this time. Recently published and ongoing research projects have focused on issues relating to the determinants of costs in dementia, pension and retirement decisions, economics of disability, and health inequalities in older populations.

Health Policy Analysis

Our fourth objective is to conduct research to inform policy and practice through the generation of evidence for the holistic analysis of illness, intervention, or policy that targets individuals, their families and friends across the life course.

Such evidence is generated from the application of qualitative and/or quantitative methods and considers issues such as feasibility, acceptability, outcomes, budget impact and cost.  This is relevant for informing decision-making by policy makers and practitioners in health and social care systems

The methodological expertise of HEPAC includes the following:

  • Systematic Review
  • Evidence Synthesis
  • Budget Impact Analysis
  • Societal Impact Analysis

Researchers at HEPAC apply such policy analysis methods in a range of areas in relation to health and health care. In areas of ageing, disability and mental health, HEPAC have played an important role in the design, formulation, and evaluation of health policy in Ireland in recent years.  In the area of ageing, health inequalities amongst older people is a major area of interest of the group and qualitative and quantitative studies are currently being conducted to explore the relationship between poverty and life course, with the aim of developing deprivation indicators for older people in Ireland. A major study on social exclusion among older people living in rural areas in Ireland has recently been published by members of the centre, funded by CARDI. The group has also made a significant contribution on the economics of dementia in Ireland which will form part of the national dementia strategy. In the area of disability, research undertaken incorporates a lifecycle perspective on disability by considering specific disability-related issues of relevance to children, the working age population and to older people, all in an economic context. In the thematic area of mental health, research by the group has played an important role in policy formulation in Ireland. For example, a report by members of HEPAC presented the economic case for investment in mental health services, adding to the discussion and debate of how to ensure provision of efficient and effective mental health services in Ireland. Members of HEPAC have also been involved in an evaluation of a specialist nursing service designed to reduce suicidal behaviour. Members are also currently leading the development of a Health System in Transition Report on behalf of the European Observatory as part of an international partnership within the World Health Organization Structure in collaboration with the Kings Fund in the UK.