AusHSI regularly delivers short courses on cost-effectiveness analysis but recently we had a special group of customers: health librarians from across Australia.
Having received the request for training, it was clear that the course would need to be very different to what we have delivered in the past. One of the challenges of targeting a presentation to a new audience is assessing their training needs. We spent some time thinking about what information would be most useful for a librarian. We imagined a situation where a researcher working on a cost-effectiveness analysis approaches a librarian for aid in their research. What does the librarian need to know?
That question formed the framework on which we prepared for the workshop. We only had two hours to deliver the course, so we had to be efficient. Yes, we should cover principles of cost-effectiveness and economic evaluation but we don’t need to get into mathematical formulae or normative frameworks. We need to cover relevant search terms, databases, and other resources but we can skip some of the more nitty gritty issues with methods. We wanted to make sure that a librarian who left our workshop would be a great aid to any researcher trying to find cost-effectiveness information.
Finally, the day arrived. Our first impression was positive: the training room was modern with a big flat screen monitor at each table as well as the main projector screen. The first session introduced the concepts of cost-effectiveness analysis in healthcare. We were impressed with the number of excellent questions from participants and the discussions these generated. Slides we were worried might be too dry or technical, provoked discussion. Even the representative of the sponsor (MIMS Australia) joined in with interesting comments about economic modelling and how irrationality gets included in analyses. The first session ended with a brainstorming exercise which linked well with the next session on quantifying costs and effects.
One of the themes of the discussions during the first session was the different contexts in which economic evaluations are used for decision-making. This was a topic we were light on in our slides because of the preconception we had about what librarians would be interested in.
The second session was adjusted to go through how different contexts affect how cost-effectiveness analyses are produced and used—a topic that fortunately overlaps with one of our PhD projects. We found out that a couple of the participants were working on measuring whether the service they provide as health librarians was cost-effective, so we discussed potential methods they could use to do so—how to measure costs and changes in productivity; and what could be used as a measure of effectiveness. They had some suggestions for measuring cost-effectiveness that had never occurred to us—such as using Google Analytics to measure time to seek information. But the most important lesson for us was why they were doing the cost-effectiveness analysis—like everyone else in the health sector they were feeling the budget squeeze and wanted to defend their funding.
With this discussion and questions there was less time to cover the content we scripted. There was only 15 minutes for the last session on health economics and systematic review. Thus,
the session was focused on delivering the main messages: librarians are key stakeholders in a systematic review, and a systematic review is the most reliable source of evidence.
The feedback from the participants was very positive. We weren’t expecting how interested this audience would be in cost-effectiveness research for their own sake, rather than just through their professional capacity; that they would find the methods interesting; or that they would care about how cost-effectiveness evidence is used in decision-making and its impacts on policies. Most of all, we didn’t guess that they might want to do a cost-effectiveness analysis. After all, we managed to find a common language for economists and librarians.
Greg Merlo is in the final year of PhD candidature, researching how economic evidence is used in decision-making related to infection control policy.
Victoria McCreanor is a research associate with a diverse background in law, science and health economics.
Son Nghiem is a VC research fellow with a project on the cost-effectiveness of the NDIS.