Using qualitative and mixed methods in health economics

Health Economics is a traditionally quantitative discipline, but there has increasingly been acceptance that qualitative and mixed methods can offer new insights to enhance the discipline. There are extremely few experts internationally in the use of qualitative methods in health economics, but Prof Coast (JC), University of Bristol, and PD Dr De Allegri (MDA), University of Heidelberg, are both in this very small group. There are, however, few existing links between the two research groups, despite the potential opportunities offered by the links between the two universities.

This award aims to develop links between the two research groups with a view to generating methodological and substantive research in this area. Issues that might be taken forward include generating ‘economic’ approaches to the analysis of qualitative data, using mixed methods to better understand the health economy and decision making in complementary areas, and improving use of qualitative data as a precursor to generating quantitative data. The award will faciliate reciprocal research visits between the two teams involving full day meetings between the visitors and all relevant members of the research groups (Health Economics at Bristol (HEB) in Bristol, and Health Economics and Health Financing (HEHF) in Heidelberg), providing the opportunity for methodological experts to consider issues around qualitative research within health economics. The full day meetings will concentrate on establishing areas of common interest within the core collaborative focus on qualitative and mixed methods in health economics, generating ideas for future collaboration and starting to pursue a path forward. There will also be further individual meetings on the travel days alongside this meeting. Individual meetings will provide the opportunity to identify other common interests, such as economic evaluation methodology, which could generate further collaborations across the research groups.

This research will aim to generate collaboration between groupings of health economists at the University of Bristol and the University of Heidelberg. It will achieve this by concentrating on an area of common interest: the use of methods that involve observation and interview. These methods are not commonly used to study health economics but are an area where both groups already have expertise.

The visit format was designed with the aim of increasing the chance of sustainability, by proposing visits by both partners, enhancing opportunities for discussions beyond core activities, including junior as well as senior team members and ensuring dedicated time for discussion of the core area of interest. It was anticipated that these discussions would result in: (1) an initial piece of collaborative work such as a joint manuscript; (2) exploration of funding opportunities for substantive collaboration; (3) discussion of possible joint teaching activities; and (4) development of individual links.

The first meeting for this collaboration was held between 1st and 3rd June 2016, with participants from University of Bristol visiting the University of Heidelberg Group. As well as a day long meeting on the topic of using qualitative methods within health economics, Joanna Coast from the University of Bristol gave a seminar on 'Economic evaluation and the capability approach: assessing capability wellbeing across the life course', and there was the opportunity for a separate meeting with a behavioural economist. Areas of potential collaboration were identified, including in relation to the measurement of capability wellbeing, and areas of good practice were shared between the groups and will be taken forward (for example, the use of 'thinkaloud' techniques was discussed by the Bristol group and the Heidelberg group are planning to use these in future work).