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Theme lead: Professor Julie Robotham (UKHSA)

Theme co-lead: Professor Koen Pouwels (University of Oxford)

The Establishing Population Impact Theme addresses the following key health protection need:

Evidence on value for money to guide the selection of effective interventions to reduce AMR and HCAI

Optimal and innovative methods combining health economic, econometric, and mathematical modelling to assess which interventions to prioritise, among which patient/population groups and where along the patient pathway to improve overall population health and minimise disparities in both quality of care and patient outcomes.

Key projects

• Assessment of HCAI/AMR quality indicators

• Understanding health inequalities

• Estimating the cost of HCAI/AMR

• Modelling HCAI /AMR transmission and control

• Cost-effectiveness evaluations of HCAI/AMR management strategies

We Aim to

1. Use a wide range of variables representing infection incidence, treatment and outcomes to:

• Identify robust HCAI/AMR-related quality indicators

• Detect good- and poor-performing facilities accounting for case-mix

• Determine the extent to which variations and inequality in patient outcomes are due to modifiable

• Facility-level processes (like antibiotic treatment) or patient-level factors

2. Assess societal aversion to health inequalities through national surveys to be able to value the effect of intervention on health inequality in distributional cost-effectiveness analyses.


3. Assess the cost of defined resistant infections (e.g. Gram-negative BSI) and use this to compare value for money of interventions.

• Predict HCAI/AMR trajectories accounting for demographics, climate change, and NHS workforce trajectories

• Assess the costs of AMR infections

• Conduct model-based evaluations to prioritise interventions (AMS, diagnostics, IPC, vaccination) considering different patient groups and settings using distributional cost-effectiveness analyses

• Estimate the impact of product characteristics on the cost-effectiveness of upcoming interventions to aid the development of target product profiles

• Use detailed information on patient movements through the healthcare ecosystem (including specific vulnerable subgroups at higher risk) to estimate the most cost-efficient surveillance strategies considering both which facilities and which patients to focus on.

4. Use detailed information on patient movements through the healthcare ecosystem (including specific vulnerable subgroups at higher risk) to estimate the most cost-efficient surveillance strategies considering both which facilities and which patients to focus on.