A systematic review of health economic evaluations in occupational therapy

Introduction: There is a growing need for health professions to demonstrate cost-effectiveness in an increasingly financially constrained climate. High quality health economic evaluations are recommended by the National Institute for Health and Care Excellence. This systematic review examines the quality of health economic evaluations of occupational therapy interventions. Method: A systematic search was conducted, and 262 potential review papers were screened, with nine being selected for review. The consolidated health economic evaluation reporting standards statement alongside a devised scoring frame was used to appraise the quality of the review papers. Results: The nine papers appraised varied considerably in quality. The main concerns were: quality of the original clinical study; statement of cost-perspective and time horizon, choice of outcome units; presentation of included costs; use and reporting of uncertainty analyses. Conclusion: The current low number and variable quality of health economic evaluations are largely insufficient to inform resource allocation decisions. If occupational therapy as a profession is to flourish, as financial challenges continue to increase, it must engage more strongly with health economic evaluations and produce good quality research that incorporates health economic evaluations at a much higher quality and volume than currently. We are part of a fast evolving healthcare world, and we need to evolve with it.