HECN3010 Introduction to the Economic Evaluation of Health
August, 2023/2024
100% Resit Assignment
You are asked to investigate the most cost-effective approach to recommend for caring for patients in England aged 35 who have today begun to experience symptoms of an upper respiratory tract infection (URTI), and who would otherwise be predicted to live on average for 40 more years. Although there are many possible consequences of an URTI, assume initially that these patients will either not see any worsening of symptoms, or will progress to developing pneumonia. Patients with URTI symptoms can either be initially screened by going to an accident and emergency (A&E) department, or by calling a telephone helpline like NHS 111. You are given the following information, which has been compiled by a clinician with little background in health economics: you should note that some information may be missing, some assumptions may be dubious, and you may need to make additional plausible informed assumptions to best complete your answer.
Patients with URTI symptoms generally have an initial health-related quality of life (HRQoL) of 0.85 (i.e. a health state that would represent 0.85 QALYs if experienced for a year).
If a patient attends A&E, they will be seen and diagnosed in person. If a patient calls 111, they will be given advice by telephone after being asked to describe their symptoms.
Different methods of screening are associated with different costs, and with different outcomes. Based on observational data, we think the below is true:
· The condition of the vast majority (99%) of patients experiencing URTI symptoms will improve in under a week, and if untreated these patients will suffer a 0.80 unit fall in QoL for on average five days, before returning to their initial health state, and no reduction in life expectancy.
· 1% of patients will however develop pneumonia within two days, which is associated with 40% mortality if untreated. It is also associated with a 1.1 fall in HRQoL for 14 days, and a reduction in quality of life of 0.1 (compared to the baseline of 0.85) thereafter if the individual survives.
· Patients who immediately call 111 will be advised to isolate at home and take paracetamol (costing 20p per day, and which the individual can buy out-of-pocket).
Patients who immediately attend A&E will be admitted to hospital for monitoring for two days, if the hospital has spare capacity.
· The cost of one A&E attendance is about £400.
· Patients who are admitted to hospital cause additional costs of £400 per day.
· Patients who develop pneumonia receive additional treatment costing on average £800.
Based on this, which method of screening, if any, should you recommend to patients? What do you expect the incremental cost-effectiveness ratio (ICER) associated with the use of this treatment rather than the other to be? Show all of your working and discuss any weaknesses with the information you have been given.
In answering the question, you may wish to consider:
· What is the best way to illustrate the decision being made here?
· What additional assumptions, if any, do you need to make to answer this question?
· Are any of the assumptions stated in this brief unrealistic?
· Is there anything you would propose to make your results more robust?
Please note: this is an illustrative example designed for educational purposes. It should not be taken as a representation of clinical reality, does not constitute medical advice, and should not be taken as such.
Assignments should be a maximum of 2,500 words in length.
All coursework assignments that contribute to the assessment of a module are subject to a word limit, as specified in the online module handbook in the relevant module area of the MINERVA.  The word limit is an extremely important aspect of good academic practice, and must be adhered to.  Unless stated specifically otherwise in the relevant module handbook, the word count includes EVERYTHING (i.e. all text in the main body of the assignment including summaries, subtitles, contents pages, tables, supportive material whether in footnotes or in-text references) except the main title, reference list and/or bibliography and any appendices.  It is not acceptable to present matters of substance, which should be included in the main body of the text, in the appendices (“appendix abuse”).  It is not acceptable to attempt to hide words in graphs and diagrams; only text which is strictly necessary should be included in graphs and diagrams.
You are required to adhere to the word limit specified and state an accurate word count on the cover page of your assignment brief.  Your declared word count must be accurate, and should not mislead. Making a fraudulent statement concerning the work submitted for assessment could be considered academic malpractice and investigated as such.  If the amount of work submitted is higher than that specified by the word limit or that declared on your word count, this may be reflected in the mark awarded and noted through individual feedback given to you.
The deadline date for this assignment is 12:00:00 noon on Monday 12^th August 2024.
An electronic copy of the assignment must be submitted to the Assignment Submission area within the module resource on the Blackboard MINERVA website no later than 12:00:00 noon prompt on the deadline date.
Faxed, emailed or hard copies of the assignment will not be accepted.  
Failure to meet this initial deadline will result in a reduction of marks, details of which can be found at the following place:
https://lubswww.leeds.ac.uk/TSG/coursework/
SUBMISSION
Please ensure that you leave sufficient time to complete the online submission process, as upload times can vary. Accessing the submission link before the deadline does NOT constitute completion of submission.  You MUST click the ‘CONFIRM’ button before 12:00:00 noon for your assignment to be classed as submitted on time, if not you will need to submit to the Late Area and your assignment will be marked as late.  It is your responsibility to ensure you upload the correct file to the MINERVA, and that it has uploaded successfully.
It is important that any file submitted follows the conventions stated below:
FILE NAME
The name of the file that you upload must be your student ID only.
ASSIGNMENT TITLE
During the submission process the system will ask you to enter the title of your submission. This should also be your student ID only.
 


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