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The economic evaluation of end of life care (EconEndLife)
Start date: Apr 1, 2011, End date: Sep 30, 2015 PROJECT  FINISHED 

Making choices about the health care that we provide in society is a fundamental and unavoidable issue. Economic evaluation aids this decision-making by supplying information about costs and benefits of different interventions. For end of life care, however, current evaluative frameworks are inadequate because they focus only on health and only on the patient. Amartya Sen’s capability approach offers an alternative and appropriate framework for evaluating end of life care and this programme aims to build on my ground-breaking work in the application of Sen’s approach to measurement within economic evaluation. Six key tasks will be undertaken: (i) defining the ‘end of life’ period using semi-structured interviews with key stakeholders; (ii) assessing the construct validity and sensitivity to change of a descriptive system for evaluating capabilities related to end of life care; (iii) eliciting values for this descriptive system from the general public and patients at the end of life using the best-worst scaling technique; (iv) developing a descriptive system to evaluate the impact on families’ capabilities of end of life care, using in-depth interviews to develop conceptual attributes; (v) conducting exploratory theoretical and methodological work on weighting across measures; and (vi) exploring views of the public and key stakeholders about appropriate decision-rules for end of life care, using a combination of focus groups and in-depth interviews. The work involves frontier research at the interface between health, economics and human development. It will address the significant methodological issues associated with the economic evaluation of end of life care and so advance the state-of-the-art to a point where robust economic evaluation of end of life care is feasible.

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