Economic Evaluations from the Patient Perspective: Highlighting the Need for Such a Perspective

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Organizations, Systems, and Providers".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 1018

Editor


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Guest Editor
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
Interests: economic evaluation; patient perspective; affordability

Special Issue Information

Dear Colleagues,

This Special Issue will focus on economic evaluations and issues surrounding the patient perspective. Often, economic evaluations focus on the societal or payer perspective; however, it is common for there to be issues from the patient perspective that are important to decision-makers that are lost within these other perspectives and need to be considered in certain cases. Prime amongst these issues is affordability, since many innovations now increasingly cross the boundary between medical devices and pharmaceuticals, such that third-party payments come out of a new budget silo with different cost-sharing provisions. Thus, the next advancement within a therapeutic class could make the patient substantially more out-of-pocket compared with if they received the current standard of care. There are also a number of other issues that a patient perspective economic evaluation will highlight that are largely ignored within other perspectives. This Special Issue attempts to address these shortcomings by presenting a case for including such a perspective, at times, in health technology assessments.

Dr. Eric Nauenberg
Guest Editor

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Keywords

  • economic evaluation
  • patient perspective
  • affordability

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Published Papers (1 paper)

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Research

17 pages, 538 KB  
Article
The Hidden Costs of ICU Caregiving: Economic, Mental Health and Spiritual Consequences
by Fotios Tatsis, Mary Gouva, Elena Dragioti, Foteini Veroniki, Konstantinos Stamatis, Georgios Papathanakos and Vasilios Koulouras
Healthcare 2026, 14(4), 487; https://doi.org/10.3390/healthcare14040487 - 14 Feb 2026
Cited by 2 | Viewed by 673
Abstract
Background: Family caregivers of intensive care unit (ICU) patients face a double burden: the psychological toll of critical illness and the economic and occupational disruptions that often accompany prolonged caregiving. While prior research has examined caregiver distress, few studies have systematically integrated [...] Read more.
Background: Family caregivers of intensive care unit (ICU) patients face a double burden: the psychological toll of critical illness and the economic and occupational disruptions that often accompany prolonged caregiving. While prior research has examined caregiver distress, few studies have systematically integrated economic, psychological and spiritual domains over long-term follow-up. Methods: This study presents a cross-sectional analysis conducted at long-term follow-up examining economic, occupational, psychological, and spiritual correlates among family caregivers of former ICU patients. From an initial cohort of 189 caregivers, 92 participated in a five-year follow-up, completing validated psychometric instruments (SCL-90-R, SpREUK, CD-RISC-10, Heartland Forgiveness, F-COPES). Multivariate regression models were used to identify predictors of psychological and spiritual outcomes, while cluster analysis explored heterogeneity in caregiver profiles. Results: Job loss emerged as a strong predictor of anxiety and hostility, while reduced working hours showed a protective association against depression and anxiety. Financial burden was less consistently associated with psychopathology. Spirituality demonstrated an ambivalent pattern of correlational associations: while dimensions such as trust and reflection were linked to adaptive coping, higher levels of spiritual engagement were also associated with elevated depressive symptoms, suggesting a reactive rather than purely protective role. Resilience and coping resources (e.g., reframing, forgiveness, personal competence) mitigated distress, whereas neuroticism amplified vulnerability. Cluster analysis revealed three distinct caregiver subgroups: a high-burden cluster (severe psychopathology and economic strain), a moderate cluster with mixed spiritual and psychological engagement and a resilient cluster with minimal burden. Conclusions: This study highlights that economic stressors are not peripheral but central drivers of caregiver distress and that spirituality, although valued, may operate in both adaptive and maladaptive ways. Tailored interventions must integrate financial protection, psychological support and sensitive spiritual care to address the multidimensional reality of ICU caregiving. Full article
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