Absence of information on cost of healthcare and disease has impact on how decisions are made

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Health surveys in Ireland are not capturing enough information about patients’ use and cost of health services and the economic consequences of disease, according to a new review by health economists at RCSI University of Medicine and Health Sciences and University College Cork.

Such information is important for planning future healthcare provision and public health prevention.

Published in BMC Health Economics Review, the review finds that information to assess cost of healthcare and economic consequences of disease is poorly captured in existing national health surveys. Data gaps are particularly evident in relation to older age, health service utilisation (in particular specialist services), school/work productivity and psychosocial wellbeing of children.

The researchers identified 27 surveys that contain information on health or healthcare in Ireland; less than two thirds of those surveys include data on healthcare use. Furthermore, within those surveys containing healthcare use data, the researchers found varying levels of detail reported and limited assessment of pharmaceutical, specialist care and hospital care use.

Researchers found only a few Irish studies that make use of existing health surveys to assess costs, while other studies collect new, disease-specific data that contain more detail about health and healthcare use. Potential reasons for this include lack of awareness or access to existing surveys, lack of detail or complete information within these surveys and researchers' concerns on the representativeness and bias of survey data.

The review highlights the potential for carefully designed health surveys to provide information for resource allocation in the absence of comprehensive electronic health records and unique patient identifiers.

Professor Jan Sorensen, Healthcare Outcomes Research Centre (HORC) at RCSI, said: "In the absence of electronic health records which are linkable through unique patient identifiers, analysis of cost must rely on collecting or using secondary healthcare-user data to assess healthcare utilisation and cost. When these surveys fail to capture reliable information on cost, we simply do not have a complete picture when making policy decisions about resource allocation. There is no question but that this has a severe impact on the efficiency of care delivery in Ireland."

The review suggests that reliable and detailed data could facilitate tailored resource allocations to individual patient and population groups, based on which the staffing and funding of healthcare services can be organised to meet current and future healthcare demands.

Dr Samira Jabakhanji, HORC researcher, said: "While Ireland is waiting for a comprehensive electronic health record system, to assess resource use and needs, future surveys should include more detailed and consistent information on healthcare utilisation, health status, demographic characteristics and health-related risk and behaviour."

Dr Aileen Murphy, Senior Lecturer, Department of Economics, UCC, added that: "Enhancing the usability of existing health surveys will provide valuable data and information which is absolutely necessary to inform health policy decision making, which now more than ever needs to be data driven."