The Cost of Neurodevelopmental Disability: Scoping Review of Economic Evaluation Methods

Abstract

Sanjeewa Kularatna,1 Amarzaya Jadambaa,1 Sameera Senanayake,1 David Brain,1 Nadia Hawker,2 Nadine A Kasparian,3,4 Bridget Abell,1 Benjamin Auld,5 Karen Eagleson,5 Robert Justo,5 Steven M McPhail1,6 1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia; 2Metro South Health, Queensland Health, Brisbane, QLD, Australia; 3Cincinnati Children’s Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA; 4Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; 5Queensland Paediatric Cardiac Service, Queensland Children’s Hospital, Brisbane, QLD, Australia; 6Digital Health and Informatics Directorate, Metro South Health, Brisbane, QLD, AustraliaCorrespondence: Sanjeewa Kularatna, Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Australia, Tel [phone], Email [email protected]: The provision of effective care models for children with neurodevelopmental delay or disability can be challenging in resource constrained healthcare systems. Economic evaluations have an important role in informing resource allocation decisions. This review systematically examined the scope and methods of economic models evaluating interventions for supporting neurodevelopment among children with common neurodevelopmental disorders and identified methods of economic models and presented policy implications. This scoping review employed the Arksey and O’Malley framework and aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Four electronic databases were systematically searched to identify eligible model-based economic evaluations of neurodevelopmental care models published since 2000. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to assess quality of reporting. Data were systematically extracted, tabulated, and qualitatively synthesised across diagnostic categories. Searches identified 1431 unique articles. Twelve studies used a decision analytic model to evaluate care for neurodevelopmental disorders and were included in the review. Included studies focused on attention-deficit/hyperactivity disorder (ADHD, n=6), autism spectrum disorder (ASD, n=3), cerebral palsy (n=2), and dyslexia (n=1). The most used decision analytic modelling approach was a Markov model (n=6), followed by a decision tree (n=3), and a combination of decision tree and Markov model (n=3). Most studies (n=7) adopted a societal perspective for reporting costs. None of the reviewed studies modelled impact on families and caregivers. Four studies reported cost-savings, three identified greater quality of life, and three identified cost increases.Keywords: neurodevelopmental disorders, attention-deficit/hyperactivity disorder, decision analytic models, economic evaluation

Keywords

• neurodevelopmental disorders
• attention-deficit/hyperactivity disorder
• decision analytic models
• economic evaluation.