Assessing the quality of Swedish health economics research

Abstract

The sub-discipline of health economics has grown rapidly over the last ten years. Swedish researchers were among the first in the field and have featured prominently in its development. Therefore the review of Swedish Health Economics Research, commissioned by FAS (the Swedish Council for Working Life and Social Research) published as a supplement to this journal [1], provided an excellent opportunity to take stock of past achievements and to make recommendations for the future. The first task of the evaluation group was to define what is meant by ‘health economics’. This is not a straightforward task, as health economics is closely associated with social medicine and public health, with many studies being undertaken by multidisciplinary teams. In the end the evaluation group opted for the definition outlined by Williams (1987), shown in Figure 3.1 of the supplement. This considers health economics to consist of eight areas of research, including theoretical topics, such as ‘what is health?’ and applied topics, such as ‘microeconomic evaluation at the treatment level’. However, one caveat was applied; namely, the research in any of the eight areas had to adopt a theoretical and/or empirical perspective consistent with the parent discipline (economics). The methods applied by the evaluation group comprised three elements. First, an inventory of Swedish health economics research was compiled by surveying those university research units, government and non-government agencies thought to be active in the field. (Private, for profit, organisations such as pharmaceutical companies were excluded.) Secondly, a bibliometric analysis of the Swedish health economics literature from 1986 to 2004 was conducted. Finally, face-to-face interviews were held with representatives of the main health economics research groups and the main users of research, such as national and regional governments. The inventory survey, conducted by Marianne Hanning, found that health economics research was undertaken in many parts of Sweden, with the largest concentrations of researchers being in Stockholm, Lund/Malmo and Linkoping. Some researchers were based in economics departments, others in medical schools, with successful research being undertaken in either location. The bibliometric analysis, conducted by Olle Persson, showed that the publication record of Swedish researchers had been impressive, with Sweden ranked fifth in the world in publications in the top ranked journals in the field. (The normal position of Sweden in such surveys is rank 12.) The bibliometric maps, shown in Figures 5.1 and 5.2 of the supplement, also illustrate the ways in which Swedish researchers have collaborated with one another and with researchers from other countries. The research groups were also asked to identify their five ‘best’ publications, in terms of methodological contribution or policy impact, and the PhD students they had supervised. This showed that, although research had been conducted in all the 8