Health Economics & Health Policy (HEHP@Bristol), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK.
Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
Soc Sci Med. 2024 Nov;360:117311. doi: 10.1016/j.socscimed.2024.117311. Epub 2024 Sep 8.
The capability approach provides a broad evaluative space for making funding decisions for health and care interventions, with capability wellbeing as the outcome of value. A range of capability measures have been developed for the economic evaluation of health and care interventions for adults. However, such measures have not been previously developed for children and young people for this purpose and may be valuable. This study aimed to identify important capabilities for children and young people aged 11-15, and to develop these into attributes for an economic measure that can inform funding decisions. Thirty-three qualitative in-depth interviews were undertaken with children and young people aged 11-15 (n = 19) and parents (n = 14) in urban and rural areas of England between September 2019 and November 2021. Purposeful maximum variation sampling ensured representation from different backgrounds. Children and young people were asked to think of things important to them and place these on sticky notes around a drawing/photograph of themselves; the interview asked them about these important things. Parents were asked to identify factors that enhanced and negatively impacted their child's quality of life. Analysis using constant comparison facilitated exploration of similarities and differences in important capabilities. A second phase of semi-structured interviews with children and young people (n = 15) explored how these attributes should be expressed in a meaningful way. Eight overarching capability wellbeing themes were identified, with some variation across children and young people, and parent groups: Fun and enjoyment; Learning and experiencing; Attachment; Emotional security andsupport; Achievement; Identity and choice; Physical safety; Aspiration. Potentially, this information will help to provide an alternative approach to the measurement of benefits to children and young people for economic evaluation of health and care interventions, one that will be better able to capture benefits associated with interventions to improve the social determinants of health.
能力方法为医疗保健干预措施的资金决策提供了广泛的评估空间，以能力福祉作为价值的结果。已经为成人健康和保健干预措施的经济评估开发了一系列能力措施。然而，这些措施以前没有为儿童和青少年开发过，因此可能具有价值。本研究旨在确定 11-15 岁儿童和青少年的重要能力，并将这些能力发展为经济衡量标准的属性，以告知资金决策。2019 年 9 月至 2021 年 11 月期间，在英格兰城乡地区对 11-15 岁的儿童和青少年（n=19）和父母（n=14）进行了 33 次深入的定性访谈。目的明确的最大变异抽样确保了来自不同背景的代表性。要求儿童和青少年思考对他们重要的事情，并将这些事情贴在自己的绘画/照片周围的便利贴上；采访询问他们这些重要的事情。要求父母确定增强和负面影响孩子生活质量的因素。使用恒定比较进行的分析促进了对重要能力的相似性和差异性的探索。对儿童和青少年（n=15）进行了第二阶段的半结构化访谈，探讨了这些属性应以何种有意义的方式表达。确定了八个总体能力福祉主题，儿童和青少年以及父母群体之间存在一些差异：乐趣和享受；学习和体验；依恋；情感安全和支持；成就；身份和选择；身体安全；抱负。这些信息可能有助于为儿童和青少年的健康和保健干预措施的经济评估提供一种替代的收益衡量方法，这种方法将更能捕捉与改善健康的社会决定因素相关的干预措施的收益。
