Harkness Project Title: The Economics of Prevention in Health Care - The Business Case for Quality
Mentors: Edward Wagner, M.D., and Eric Larson, M.D.
Placement: Group Health Cooperative of Puget Sound
Biography at time of Harkness Fellowship: Rhiannon Tudor Edwards is senior research fellow in health economics and the founding director of the Centre for the Economics of Health, University of Wales, Bangor. She is a graduate of the University of Wales, University of Calgary, Canada, and The University of York, U.K. Edwards provides health policy support to the Welsh Assembly Government. Her interests span economic evaluation alongside clinical trials, the impact of political devolution on health policy and she contributes to the policy evidence base for tackling the wider economic determinants of population health.
Project: Edwards’ project examined to what extent there is a business case for prevention services from the perspective of different stakeholders (health insurers, employers, and government). She first conducted a structured literature review on prevention in U.S. health care, including its costs and benefits. She then conducted a series of site visits to research centers and to stakeholders within the Puget Sound area – a large health maintenance organization, several large and small employers, and a disease management company.
Career Activity Since Fellowship
- Professor and Founding Director of Health Economics Research; Co-Director, Centre for Health Economics and Medicines Evaluation, Bangor University
- Visiting Scholar Award, Chicago Centre for Excellence in Health Promotion Economics, University of Chicago, 2005
Current Positions: (updated 10/2017)
- Professor of Health Economics, Bangor University
- Founding Director, Health Economics Research, Bangor University
- Co-Director, Centre for Health Economics and Medicines Evaluation, Bangor University
E-Mail: [email protected]
Selected Publications
O'Brien TD, Noyes J, Spencer LH, Kubis HP, Edwards RT, Bray N, Whitaker R. Well-being, health and fitness of children who use wheelchairs: Feasibility study protocol to develop child-centred 'keep-fit' exercise interventions. J Adv Nurs. 2014 Jul 29.
Bray N, Noyes J, Edwards RT, Harris N. Wheelchair interventions, services and provision for disabled children: a mixed-method systematic review and conceptual framework. BMC Health Serv Res. 2014 Jul 17;14:309.
Jones C, Edwards RT, Hounsome B. Qualitative exploration of the suitability of capability based instruments to measure quality of life in family carers of people with dementia. ISRN Family Med. 2014 Mar 4;2014:919613.
O'Brien TD, Noyes J, Spencer LH, Kubis HP, Hastings RP, Edwards RT, Bray N, Whitaker R. 'Keep fit' exercise interventions to improve health, fitness and well-being of children and young people who use wheelchairs: mixed-method systematic review protocol. J Adv Nurs. 2014 May 18..
Mountain GA, Hind D, Gossage-Worrall R, Walters SJ, Duncan R, Newbould L, Rex S, Jones C, Bowling A, Cattan M, Cairns A, Cooper C, Edwards RT, Goyder EC. ‘Putting Life in Years' (PLINY) telephone friendship groups research study: pilot randomised controlled trial. Trials. 2014 Apr 24;15:141.
Whitaker R, Hendry M, Booth A, Carter B, Charles J, Craine N, Edwards RT,Lyons M, Noyes J, Pasterfield D, Rycroft-Malone J, Williams N. Intervention Now To Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, qualitative and realist synthesis of implementation factors and user engagement. BMJ Open. 2014 Apr 10;4(4):e004733.
Quinn C, Anderson D, Toms G, Whitaker R, Edwards RT, Jones C, Clare L. Self-management in early-stage dementia: a pilot randomised controlled trial of the efficacy and cost-effectiveness of a self-management group intervention (the SMART study). Trials. 2014 Mar 8;15:74.
Charles JM, Bywater TJ, Edwards RT, Hutchings J, Zou L. Parental depression and child conduct problems: evaluation of parental service use and associated costs after attending the Incredible Years Basic Parenting Programme. BMC Health Serv Res. 2013 Dec 18;13:523.
Christopher N Hurt, Kirsty Roberts, Trevor K Rogers, Gareth O Griffiths, Kerry Hood, Hayley Prout, Annmarie Nelson, Jim Fitzgibbon, Allan Barham, Emma Thomas-Jones, Rhiannon Tudor Edwards, Seow Tien Yeo, William Hamilton, Angela Tod and Richard D Neal A feasibility study examining the effect on lung cancer diagnosis of offering a chest X-ray to higher-risk patients with chest symptoms:protocol for a randomized controlled trial. Trials 2013 14:405.
Edwards et al.: Cost-effectiveness of a national exercise referral programme for primary care patients in Wales: results of a randomised controlled trial. BMC Public Health 2013 13:1021.
Edwards R.T., Charles J.C., Lloyd-Williams H. A systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues. BMC Public Health 2013, 13:1001.
Russell I., Edwards R., Glidden A., Ingledew D., Russell D., Whitaker R. and Park K. Cancer of Oesophagus or Gastricus-New Assessment of Technology of Endosonography (COGNATE): report of pragmatic randomised trial. Health technology assessment (Winchester, England), 2013, 17:39, 1-170.
Noyes J, Edwards RT, Hastings RP, Hain R, Totsika V, Bennett V, Hobson L, Davies GR, Humphreys C, Devins M, Spencer LH, Lewis M. Evidence-based planning and costing palliative care services for children: novel multi-method epidemiological and economic exemplar. BMC Palliative Care 2013, 12:18
Thomson C.E., Beggs I., Martin D.J., McCaldin D., Edwards R.T., Russell D., Yeo S.T., Russell I.T. and Gibson J.N.A. Methylprednisolone injections for the treatment of Morton Neuroma: A patient-blinded randomized trial. The Journal of Bone & Joint Surgery, 2013 v 95-a d number 9 d; 790-79.
Woods R, Bruce E, Edwards R, Elvish R, Hoare Z, et al. REMCARE: reminiscence groups for people with dementia and their family caregivers - effectiveness and cost-effectiveness pragmatic multicentre randomised trial. Health Technol Assess 2012;16(48).
Thomson C E, Beggs I, Martin D, McCaldin D, Edwards R T, Russell D, Yeo S T, Russell I T, and Gibson J N A. Steroid injections (Methylprednisolone) in the treatment of Morton's neuroma: patient-blind randomized trial," The Journal of Bone and Joint Surgery 2012.
Charles, J.M., Edwards, R.T., Bywater, T., & Hutchings, J. Micro-costing in public health economics: steps towards a standardised framework, using the Incredible Years Toddler Parenting Programme as a worked example, Prevention Science 2012.
Jones C, Edwards RT & Hounsome B. Health economics research into supporting carers of people with dementia: A systematic review of outcome measures, Health and Quality of Life Outcome. 2012. 10:142.
Margrain, T.H., Nollett, C., Shearn, J., Stanford, M., Edwards, R.T., Ryan, B., Bunce, C., Casten, R., Hegel, M.T., & Smith, D.J. The Depression in Visual Impairment Trial(DEPVIT): trial design and protocol. BMC Psychiatry 2012, 12:57.
Murphy S, Edwards, RT, Williams N, Raisenen L, Moore G, Linck P, Hounsome N, Ud Din, N, and Moore L. An evaluation of the effectiveness and cost effectiveness of the National Exercise Referral Scheme in Wales, UK: a randomised controlled trial of a public health policy initiative Journal of Epidemiology and Community Health 2012.
Jones C, Edwards RT, Hounsome B. A systematic review of the cost-effectiveness of interventions for supporting informal caregivers of people with dementia residing in the community. International Psychogeriatrics 2012. 24(1):6-18.
K.Seers, K.Cox, N.J.Crichton, R.T.Edwards, A.C.Eldh, C.A.Estabrooks, G.Harvey, C.Hawkes, A.Kitson, P.Linck, G.McCarthy, B.McCormack, C.Mockford, J.Rycroft-Malone, A.Titchen, L.Wallin. FIRE (Facilitating Implementation of Research Evidence): a study protocol. Implementation Science 2012, 7:25.
S.T.Yeo, R.T.Edwards, S.D.Luzio, J.M.Charles, R.L.Thomas, J.M.Peters, D.R.Owens. Diabetic retinopathy screening: perspectives of people with diabetes, screening intervals and costs of attending screening. Diabetic Medicine, 2012, 29(7), 878-885.
S.T.Yeo, R.T.Edwards, E.A.Fargher, S.D.Luzio, R.L.Thomas, D.R.Owens. Preferences of people with diabetes for diabetic retinopathy screening: A discrete choice experiment. Diabetic Medicine, 2012, 29(7), 869-877.
Noyes, J, Edwards, RT. EQ-5D for the Assessment of Health-Related Quality of Life and Resource Allocation in Children: A Systematic Methodological Review. Value in Health 2011; 14 (8) : 1117–1129.
Noyes, J & Edwards R.T. (2011) EQ-5D for the Assessment of Health-Related Quality of Life and Resource Allocation in Children: A Systematic Methodological Review. Value in Health, 14, 1117-1129.
Edwards RT, Neal RD, Linck P, Bruce N, Mullock L, Nelhans N, Pasterfield D, Russell D, Russell I, Woodfine L, on behalf of the CHARISMA study group. Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised trial. Br J Gen Pract 2011.
Woodfine L, Neal RD, Bruce N, Edwards RT, Linck P, Mullock L, Nelhans N, Pasterfield D, Russell D, Russell I, on behalf of the CHARISMA study group. Enhancing ventilation in homes of children with asthma: pragmatic randomised trial. Br J Gen Pract 2011.
Williams, N. Amoakwa, A. Belcher, J. Edwards, R.T. Hassani, H. Hendry, M. Burton, K. Lewis, R. Hood, K. Jones, J. Bennett, P. Linck, P. Neal, R.D. Wilkinson, C. Activity Increase Despite Arthritis (AÏDA):phase II randomised controlled trial of an activemanagement booklet for hip and knee osteoarthritis in primary care. Br J Gen Pract 2011.
Hounsome B, Edwards R.T, Hounsome N, Edwards-Jones G. Psychological Morbidity of farmers and non-farming Population- Results from a UK Survey. Community Mental Health Journal 2011.
Jones S, Edwards RT. Diabetic retinopathy screening: A systematic review of the economic evidence. Diabetic Med 2010 Mar;27(3):249-56.
Charles, J.M., Edwards, R.T., & Bywater, T. Parenting Interventions: a systematic review of the economic evidence. Child; Care, Health and Development 2011.
C.Dickinson, P. Linck, R. T. Edwards, A. Binns, C. Bunce, R. Harper, J. Jackson, J. Lindsay, A. Suttie, J. Wolffsohn, M. Woodhouse, T. Margrain. A Profile of Low Vision Services in England: The Low Vision Service Model Evaluation (LOVSME) project. Eye 2010.
A. M. Binns, C. Bunce, C. Dickinson, R. Harper, R. T. Edwards, M. Woodhouse, P. Linck, A. Suttie, J. Jackson, J. Lindsay, J. Wolffsohn, L. Hughes, T. H. Margrain. How Effective and cost-effective is Low Vision Service Provision? A Systematic Review. Survey of Opthamology. 2010.
Hounsome N, Orrell M, and Edwards RT. EQ-5D as a quality of life measure in people with dementia and their carers: evidence and key issues. Value in Health 14(2):390-399 2010.
J. P. Noyes, A. Williams, D. Allen, P. Brocklehurst, C. Carter, J. W. Gregory, C. Jackson , M. Lewis , L. Lowes , I. T. Russell , J. Rycroft-Malone , J. Sharp , M. Samuels , R. T. Edwards and R. Whitaker. Evidence into practice: evaluating a child-centred intervention for diabetes medicine management: The EPIC Project. BMC Pediatrics 2010, 10:70.
I.T.Russell, R.T.Edwards, A.E. Gliddon, D.K.Ingledew, D.Russell, R. Whitaker, S.T.Yeo, S.E. Attwood, H. Barr, S. Nanthakumaran and K.G.M. Park,Cancer of Oesophagus or Gastricus- New Assessment of Technology of Endosonography (COGNATE): report of pragmatic randomised trial. HTA. 2010
A. M. Binns, C. Bunce, C. Dickinson, R. Harper, R. T. Edwards, M. Woodhouse, P. Linck, A. Suttie, J. Jackson, J. Lindsay, J. Wolffsohn, L. Hughes, T. H. Margrain. How Effective and cost-effective is Low Vision Service Provision? A Systematic Review. Survey of Opthamology 2010.
N. Hounsome, M. Orrell, and R.T. Edwards. EQ-5D as a quality of life measure in people with dementia and their carers: evidence and key issues. Value in Health 2010.
T. Bywater, J. Hutchings, P. Linck, C. Whitaker, D. Daley, S. T. Yeo and R. T. Edwards. Incredible Years parent training support for foster carers in Wales: a multi-centre feasibility study. Child: Care, Health and Development 2010.
J. P. Noyes, A. Williams, D. Allen, P. Brocklehurst, C. Carter, J. W. Gregory, C. Jackson , M. Lewis , L. Lowes , I. T. Russell , J. Rycroft-Malone , J. Sharp , M. Samuels , R. T. Edwards and R. Whitaker. Evidence into practice: evaluating a child-centred intervention for diabetes medicine management: The EPIC Project. BMC Pediatrics 2010, 10:70.
Murphy S, Raisanen L, Moore G. Edwards R T Linck, P et al A pragmatic randomised controlled trial of the Welsh National Exercise Referral Scheme: protocol for trial and integrated economic and process evaluation, BMC Public Health 2010; 10, 352. 2010.
Woods R T, Bruce E, Edwards R T, Hounsome B, Keady J, Moniz-Cook E D, Orrell M and Russell I T. Reminiscence groups for people with dementia and their family carers: pragmatic eight-centre randomised trial of joint reminiscence and maintenance versus usual treatment: a protocol. Trials 2009, 10:64.
Paul Cross , Rhiannon T. Edwards, Philip Nyeko and Gareth Edwards-Jones, The Potential Impact on Farmer Health of Enhanced Export Horticultural Trade between the U.K. and Uganda Int. J. Environ. Res. Public Health 2009, 6(5), 1539-1556.
Bywater T, Hutchings J, Daley D, Whitaker C, Yeo ST, Jones K, Eames C, Edwards RT. Long term effectiveness of a parenting intervention in Sure Start Services in Wales in children at risk of developing conduct Disorder. British Journal of Psychiatry 2008.
Edwards RT, Hounsome B, Linck P, Russell IT. Economic evaluation alongside pragmatic randomised trials: developing a Standard Operating Procedure for clinical trials units. Trials 14; 64 -65.
Edwards-Jones G, Mila L, Canals J, Hounsome N, Turning M, Koerber , Hounsome B, Cross P, York EH, Hospido A, Plassmann K, Harris I, Edwards RT, Day GAS, Tomos AD, Cowell SJ and Jones DLB. Testing the assertion that ‘local food is best’: the challenges of an evidence based approach. Trends in Food Science & Technology, 2008 19: 265-274.
Linck P, Tunnage B, Hughes D, Tudor Edwards R. Charitable contributions to funding cancer services for children and young people in England and Wales. The Journal of Child Health Care 2008 ;12 (2) 156-168.
Linck P, Tunnage B, Hughes D, Tudor Edwards R. Charitable contributions to funding cancer services for children and young people in England and Wales. The Journal of Child Health Care 2008.
Willcox S, Seddon M, Dunn S, Edwards RT, Pearse J, Tu JV. "Measuring and Reducing Waiting Times: Cross-National Comparison Of Strategies," Health Affairs 2007; 26(4): 1078–1087.
Edwards RT. Blind Faith And Choice, Health Affairs 2005, Vol 24, Issue 6, 1624–1628.
Edwards RT. Economic evaluation and society's health values: View from the other side of the pond, BMJ Letter, Feb 2005; 330:311.
Edwards RT. "Health Economics, Economic Evaluation and Society's Health Values: A view from the other side of the pond" BMJ Rapid Response, 23 November 2004
Edwards RT. "Shortage of Flu Vaccine in Washington State: Rationing or rational philanthropy?" BMJ Rapid Response, 11 October, 2004.
Muntz R, Hutchings J, Edwards RT, Hounsome B, and O'Ceilleachair A (2004). Economic Evaluation of Treatments for children with severe behavioural problems. Journal of Mental Health Policy and Economics, 7:1–13.
Williams NH, Edwards RT, Linck P, Muntz R, Hibbs R, Wilkinson C, Russell I, Russell D, and Hounsome B (2004). Cost-utility analysis of steopathy in primary care: results from a pragmatic randomized controlled trial. Family Practice, 21:643–650.