1. Health Economics & Evidence
Based Practice
Stephen Kinsella
KBS
stephen.kinsella@ul.ie
www.stephenkinsella.net

2. 2 Sections

3. 3 Ideas

4. Microcosting
Simple Clinical Screening
Scores Programmes

5. <1>

6. Microcosting

7. How Much?

8. Background

9. Background
McElligott, Kinsella, & Roy (2006,
2009)

10. Background
McElligott, Kinsella, & Roy (2006,
2009)
1 Patient

11. Background
McElligott, Kinsella, & Roy (2006,
2009)
1 Patient
Birth at 24 weeks: the marginal case

12. Background
McElligott, Kinsella, & Roy (2006,
2009)
1 Patient
Birth at 24 weeks: the marginal case
212 days in hospital

13. Background
McElligott, Kinsella, & Roy (2006,
2009)
1 Patient
Birth at 24 weeks: the marginal case
212 days in hospital
Q: How much did this cost?

14. Data

15. Data
176 variables

16. Data
176 variables
17 dierent antimicrobials,

17. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’

18. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’
369 ‘diuretic-days’

19. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’
369 ‘diuretic-days’
95 ventilation days

20. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’
369 ‘diuretic-days’
95 ventilation days
86 transfusions

21. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’
369 ‘diuretic-days’
95 ventilation days
86 transfusions
83 radiological procedures including

22. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’
369 ‘diuretic-days’
95 ventilation days
86 transfusions
83 radiological procedures including
47 X-rays, 1 MRI, 35 ultrasound scans (head,
abdomen, heart)

23. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’
369 ‘diuretic-days’
95 ventilation days
86 transfusions
83 radiological procedures including
47 X-rays, 1 MRI, 35 ultrasound scans (head,
abdomen, heart)
940 laboratory investigations

24. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’
369 ‘diuretic-days’
95 ventilation days
86 transfusions
83 radiological procedures including
47 X-rays, 1 MRI, 35 ultrasound scans (head,
abdomen, heart)
940 laboratory investigations
2 x National Neonatal Transport Transfer

25. Data
176 variables
17 dierent antimicrobials,
479 ‘antibiotic days’
369 ‘diuretic-days’
95 ventilation days
86 transfusions
83 radiological procedures including
47 X-rays, 1 MRI, 35 ultrasound scans (head,
abdomen, heart)
940 laboratory investigations
2 x National Neonatal Transport Transfer
Family’s Time, Equipment Maintenance,
Refurbishment, and more

26. Day 19 Fungal Sepsis, Day 202
Transfer to Crumlin RSV Vaccination

27. Total Cost
TC = €665,219.88
1 week: cost €5,167.50
Fixed cost: €26,608.00

28. Conclusion
Very precise data implies increased
cost
TC, MC substantially larger than UK, US
estimates.
So What? Vast Budget Implications

29. /1

30. 2

31. Simple Clinical Scoring
Kellett et al 2006, 2007, 2008
Simple tests give predictive scores which
save time, effort, money, and, maybe, lives.
Big Q: How much?

32. Cost Effectiveness of Screening
for Dementia
Trepel Kinsella, 2008, Trepel’s PhD
Simple Idea, very complex implementation

33. Cochrane Review on Costing
Studies
What methods do people use when making
ec. evaluations
What numbers do they get, and why?
A meta analysis (see poster)

34. /2

35. Ching?

36. Ching?
1.
HRB/NCI Graduate fellowships in health
economics, see http://tinyurl.com/a6gbk9

37. Ching?
1.
HRB/NCI Graduate fellowships in health
economics, see http://tinyurl.com/a6gbk9
2.
HRB Health Research Project grants, see http://
tinyurl.com/axv2hc

38. Ching?
1.
HRB/NCI Graduate fellowships in health
economics, see http://tinyurl.com/a6gbk9
2.
HRB Health Research Project grants, see http://
tinyurl.com/axv2hc
3.
IRCHSS Post Graduate Scholarships, see http://
tinyurl.com/9fqug8

39. Ching?
1.
HRB/NCI Graduate fellowships in health
economics, see http://tinyurl.com/a6gbk9
2.
HRB Health Research Project grants, see http://
tinyurl.com/axv2hc
3.
IRCHSS Post Graduate Scholarships, see http://
tinyurl.com/9fqug8
4.
IRCSET Post Graduate Scholarships, see http://
tinyurl.com/7frgjk

40. Ching?
1.
HRB/NCI Graduate fellowships in health
economics, see http://tinyurl.com/a6gbk9
2.
HRB Health Research Project grants, see http://
tinyurl.com/axv2hc
3.
IRCHSS Post Graduate Scholarships, see http://
tinyurl.com/9fqug8
4.
IRCSET Post Graduate Scholarships, see http://
tinyurl.com/7frgjk
5.
Private Funding opportunities also exist, please
contact me directly for details.

41. Ching?
1.
HRB/NCI Graduate fellowships in health
economics, see http://tinyurl.com/a6gbk9
2.
HRB Health Research Project grants, see http://
tinyurl.com/axv2hc
3.
IRCHSS Post Graduate Scholarships, see http://
tinyurl.com/9fqug8
4.
IRCSET Post Graduate Scholarships, see http://
tinyurl.com/7frgjk
5.
Private Funding opportunities also exist, please
contact me directly for details.

42. Questions I want to ask
How much?
Comparison/Evaluation of different methods
Tricky data problems

43. Health Economics Evidence
Based Practice
Stephen Kinsella
KBS
stephen.kinsella@ul.ie
www.stephenkinsella.net