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Article

SEEP-CI: A Structured Economic Evaluation Process for Complex Health System Interventions

1
Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
2
Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
3
MARCH Centre, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi 00100, Kenya
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Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK
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Coventry and Warwickshire Partnership NHS Trust, Coventry CV6 6NY, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6780; https://doi.org/10.3390/ijerph17186780
Received: 11 August 2020 / Revised: 4 September 2020 / Accepted: 14 September 2020 / Published: 17 September 2020
(This article belongs to the Section Health Economics)
The economic evaluation of health system interventions is challenging, and methods guidance on how to respond to these challenges is lacking. The REACHOUT consortium developed and evaluated complex interventions for community health program quality improvement in six countries in Africa and Asia. Reflecting on the challenges we faced in conducting an economic evaluation alongside REACHOUT, we developed a Structured Economic Evaluation Process for Complex Health System Interventions (SEEP-CI). The SEEP-CI aims to establish the threshold effect size that would justify investment in a complex intervention, and provide an assessment to a decision-maker of how likely it is that the intervention can achieve this impact. We illustrate how the SEEP-CI could have been applied to REACHOUT to identify outcomes where the intervention might have impact and causal mechanisms, through which that impact might occur, guide data collection by focusing on proximal outcomes most likely to illustrate the effectiveness of the intervention, identify the size of health gain required to justify investment in the intervention, and indicate the assumptions required to accept that such health gains are credible. Further research is required to determine the feasibility and acceptability of the SEEP-CI, and the contexts in which it could be used. View Full-Text
Keywords: complex intervention; economic evaluation; health system interventions complex intervention; economic evaluation; health system interventions
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MDPI and ACS Style

Madan, J.; Bruce Kumar, M.; Taegtmeyer, M.; Barasa, E.; Singh, S.P. SEEP-CI: A Structured Economic Evaluation Process for Complex Health System Interventions. Int. J. Environ. Res. Public Health 2020, 17, 6780. https://doi.org/10.3390/ijerph17186780

AMA Style

Madan J, Bruce Kumar M, Taegtmeyer M, Barasa E, Singh SP. SEEP-CI: A Structured Economic Evaluation Process for Complex Health System Interventions. International Journal of Environmental Research and Public Health. 2020; 17(18):6780. https://doi.org/10.3390/ijerph17186780

Chicago/Turabian Style

Madan, Jason, Meghan Bruce Kumar, Miriam Taegtmeyer, Edwine Barasa, and Swaran P. Singh 2020. "SEEP-CI: A Structured Economic Evaluation Process for Complex Health System Interventions" International Journal of Environmental Research and Public Health 17, no. 18: 6780. https://doi.org/10.3390/ijerph17186780

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