Aims and benefits

The proof of effectiveness of a treatment is the primary aim of most scientific studies. These results constitute the relevance of the treatment for the treated. However, an effective treatment has economic consequences as well, that affect a larger group of people like the members of the statutory health insurance or society as a whole. These groups govern resources that are limited. Hence, it is necessary to compare the gain in health and quality of life we achieve by the effective treatment to the resources we have to spend to implement and conduct the effective program. This relation between means and effects is called the cost-effectiveness of a treatment. Its determination is the goal of this subproject.

Summarized, this subproject pursues the following goals:

  • We will determine the resource utilization that is caused by the Improve-Intervention itself and will calculate the corresponding costs.
  • We will determine the resources utilized by families who undergo the Improve Intervention, and the resources caused by those families who receive treatment-as-usual.
  • We will measure the effects of the treatments in both groups. These effects comprise stress, mental health and quality of life of parents and their children.
  • Finally, we will calculate the differences between both groups in costs and effects and put these differences in relation to each other. Based on this, we will be able to give information on the cost-effectiveness of the Improve Intervention by identifying the amount of additional resources the society has to invest to gain a certain degree of health benefits.  

Additional study information

The planned research project is a data analysis of a multicenter cooperative project (DRKS00019072), including different sub-projects. The project is based on an intervention for refugee parents with mental health issues, implemented as a randomized control trial (P1). This subproject constitutes a cost-effectiveness analysis of the IMPROVE intervention (P3).

Mentally strained refugee parents (with children between 0-6 years) with Arabic language skills, who experience elevated stress, depressive or anxious symptoms are invited to take part in the study.

The intervention will take 10 weeks and includes three aspects (4 consultations in the general practice, online parenting program Triple P and regular phone calls with a psychologist) and will be compared to a treatment as usual.

Primary outcomes are the incremental cost-effectiveness ratio (ICER) as point estimate as well as the cost-effectiveness acceptability curve (CEAC) as measure of uncertainty. Direct health care costs will be calculated. Health-care categories specific for children will be considered. As primary effect measure quality-adjusted life years (QALY) of the parents will be calculated. Secondary outcome are days without mental-health burden specifically calculated for parents and children. Additionally, we will also assess parenting style sociodemographic, psychosocial variables, physical health, stress (hair cortisol), and possible side-effects of the intervention. Time points are pre (T0), post (T1), such as a 6- (T2) and 12 -month follow-up (T3) in the major assessment. Selected variables will be also assessed directly after the treatment in the general practice (minor assessment) or during the phone calls (intermediate assessment).


Dr. Christian Brettschneider
+49 40 7410 56535

Universitätsklinikum Hamburg-Eppendorf
Martinistraße 52
20246 Hamburg



Prof. Dr. Hans-Helmut König, Universitätsklinikum Hamburg-Eppendorf, Institut für Gesundheitsökonomie und Versorgungsforschung
Dr. Christian Brettschneider, Universitätsklinikum Hamburg-Eppendorf, Institut für Gesundheitsökonomie und Versorgungsforschung