This study summarizes the concepts that have been used to date to demonstrate societal impact of healthcare interventions and establish an analytical framework to comprehensively organize and describe the different elements of societal impact.
We conducted a systematic review following Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase, gray literature from ISPOR and Value Balancing Alliance websites, and the reference lists of the identified systematic reviews. Eligible studies assessed the societal impact and described a specific approach. For each included study, we extracted relevant characteristics, such as disease area, methodology, and societal impact metrics.
From a pool of 12 525 studies, 159 were included. Studies broadly examined the societal impact of an intervention at the patients, caregivers, healthcare organizations, and the societal level. Within those categories, we identified a total of 42 different concepts of societal value. We presented a frequency count of those concepts in a hierarchical framework and analyzed the studies qualitatively. We also assessed the literature against the ISPOR value flower.
Our findings reveal recurrent themes and highlight the demand for methodological harmonization. While addressing the limitations of the studied literature from a decision-making perspective, we propose a consensus-driven path forward. Through our research, we emphasize the importance of refining the existing methods, the need for developing a standardized reporting format for future studies, and the importance of developing concise definitions for subjective concepts for societal impact of healthcare interventions.
This study provides a detailed look at how healthcare interventions affect society beyond just medical outcomes. It emphasizes the importance of understanding the broader consequences of healthcare, such as impacts on patients, caregivers, healthcare organizations, and society as a whole. The research is important because healthcare systems often focus solely on direct costs and benefits, overlooking wider societal effects. These can include productivity losses, caregiver burdens, and economic impacts on public welfare.
The review analyzed 159 studies from an initial pool of 12,525, identifying 42 different concepts of societal value. The findings show that the societal impact of healthcare interventions is often measured inconsistently, with a lack of standard methods. This inconsistency makes it challenging for healthcare decision makers, researchers, and patients to accurately assess the full value of healthcare interventions.
Key results indicate that productivity loss is the most studied societal impact, often assessed through absenteeism and presenteeism, and sometimes unpaid productivity. Other significant factors include opportunity costs, caregiver burdens, and impacts on public finance and education. The ISPOR value flower, a framework introduced to capture various elements of value, is used in many studies but not comprehensively implemented.
The review highlights the need for standardizing methods to measure societal impacts, suggesting that refined methodologies and reporting formats should be developed. Such standardization would help generate comparable outcomes, making it easier for stakeholders to make informed decisions.
For patients, understanding the societal impacts can lead to better healthcare choices and awareness of the broader benefits of treatments. Healthcare decision makers can use these insights to allocate resources more effectively, focusing on interventions that offer the greatest societal benefits. Researchers can build on this work to develop more holistic evaluation frameworks, ensuring that all potential impacts of healthcare interventions are considered.
In conclusion, the study calls for collaboration among stakeholders to agree on key concepts and methodologies. By harmonizing approaches and considering cultural contexts, the healthcare industry can enhance decision-making processes and improve overall health outcomes.