Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 18;18(1):365.
doi: 10.1186/s12913-018-3145-3.

Does multidisciplinary rehabilitation of tortured refugees represent 'value-for-money'? A follow-up of a Danish case-study

Line Bager  1 , Kristian Schultz Hansen  2 , Carit Jacques Andersen  3 , Shr-Jie Wang  4
Affiliations

Does multidisciplinary rehabilitation of tortured refugees represent 'value-for-money'? A follow-up of a Danish case-study

Line Bager et al. BMC Health Serv Res. .

Erratum in

Abstract

Background: The recent surge of asylum seekers in the European Union (EU) is raising questions about the EU's ability to integrate newcomers into the economy and into society; particularly those who need specialized services for the treatment of severe trauma. This study investigated whether rehabilitating traumatised refugees represents 'value-for-money' (VfM) in terms of intervention cost per health gain and in a long-term and societal perspective.

Methods: The economic evaluation comprised a cost-utility analysis (CUA) and a partial cost-benefit analysis (CBA). The CUA incorporated data on Quality Adjusted Life Years (QALY) for 45 patients who were treated at the Rehabilitation and Research Centre for Torture Victims, Copenhagen, Denmark, in 2001-2004 and followed for up to 2 years, to determine the incremental cost effectiveness ratio (ICER). For the CBA, data was collected for 44 patients who completed treatment between 2001 and 2004 and 44 matched controls on the waiting list, for the patients' primary health care utilisation, and personal and family labour income from 2001 to 2014. This was analysed to evaluate the Net Social Benefit (NSB) of the programme.

Results: The average cost of treatment was found to be about 32,000 USD per patient (2016 prices) with an average gain in QALY of 0.82. The treatment was cost effective according to the ICER threshold suggested by the National Institute of Health and Care Excellence (UK). At the individual level, the NSB remained negative throughout the study period. However, at the family income level the intervention proved to have been beneficial after 3 years.

Conclusion: The implication of the study is, that providing rehabilitation to severely traumatised refugee families can be an economically viable strategy, considering the economic effects observed at the family level.

Keywords: Cost-benefit; Cost-utility; Health economics; Long-term follow-up; Multidisciplinary intervention; Quality of life; Resource allocation; Torture; War.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study was conducted in accordance with the Danish guidelines issued by the Danish Data Protection Agency (2015–41-4483). The study was evaluated and approved by Statistics Denmark (705871), who ensured access to and anonymization of individual level data. All individuals whose health data was collected for the original study had provided informed consent.

Competing interests

The authors declare that they have no competing interests. The sponsor had no role in the study design, data collection and analysis. There is no relationship between authors and sponsors, which could potentially bias the results.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Conceptual model, two-pronged approach to VfM
Fig. 2
Fig. 2
Study overview
Fig. 3
Fig. 3
Sampling procedure (CBA)
Fig. 4
Fig. 4
Comparison of CBA for individual and family level
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Mpinga EK, et al. Estimating the costs of torture: challenges and opportunities. App Health Econ Health Policy. 2015;13(6):567–581. doi: 10.1007/s40258-015-0196-z. - DOI - PubMed
    1. Mpinga EK, Frey C, Chastonay P. Economic burden of torture for a refugee host country: development of a model and presentation of a country case study. ClinicoEcon Outcomes Res. 2014;6(1):165–173. - PMC - PubMed
    1. UNHCR. Global trends: forced displacement in 2015. Geneva; 2016. http://www.unhcr.org/news/latest/2016/6/5763b65a4/global-forced-displace.... Accessed 21 June 2016.
    1. Eurostat (2016) Asylum statistics, Statistics explained. Available at: http://ec.europa.eu/eurostat/en/web/products-press-releases/-/3-16032017-BP. Accessed 22 Feb 2017.
    1. Fratzscher, M. and Junker, S. (2015) ‘Integrating Refugees: A Long-Term, worthwhile Investment’, DIW Economic Bulletin, 45+46(September), pp. 612–617.

Publication types