Health economic aspects of person-centred care

Striving to improve the value delivered to patients is the fundamental goal of any healthcare system. Measuring value, by means of health economic analysis, directly informs the decision-making process as to whether a new healthcare intervention is adopted or discarded. A society’s willingness to pay, survival and health-related quality of life are key quantifiable outcomes of cost-effectiveness evaluations. However, there is a need to measure the value of interventions that exist outside of current health economic frameworks, such as the humanistic outcomes encapsulated in person-centred care (PCC).

With consideration to the literature and our own economic evaluations of studies implementing person-centred care, benefits have included improvements in self-efficacy, empowerment, disease management, clinical outcomes, and physical functioning. However, few studies have reported measurable differences in traditional outcomes of economic evaluations, such as health-related quality of life. In order for PCC to become ‘standard practice’ within the current healthcare systems, the outcomes that identify with PCC interventions need to be incorporated within evaluations. Only through standardising the methods for evaluating PCC interventions can informed decisions be made that truly represent the benefits to all stakeholders.

We are thus conducting economic evaluations of person-centred care implemented in different contexts and populations, with both traditional health economic methods and with outcomes aligned with the ethics of person-centredness.

The project developing a core outcome set for the economic evaluation of person-centred interventions, including eHealth, thus investigates the knowledge demands among ivolved decision makers.

Data collection includes a systematic literature review and an expert panel study, in order to develop consensus of preferred outcomes within stakeholder groups. Included stakeholders groups comprise of patients, healthcare providers, researchers and government representatives, all key decision-makers involved in the development and implementation of new care models. Identified preferred outcomes will further be compared to those previously used in evaluations in the literature. This will allow for more accurate decision-making from stakeholder groups in the design, implementation and evaluation of person-centred care, as well as increasing transparency in healthcare decision-making.

Publications

Methodological development and literature syntheses:

Elhassan H, Pardhan S, Hewage R, Harvey BP, Gyllensten H. Costs and Health Outcomes in Economic Evaluations of Person-Centered Care: A Systematic Review. Value Health. 2025 Jun;28(6):852-865. doi: 10.1016/j.jval.2025.03.013. Epub 2025 Apr 11. PMID: 40222408.

Harvey, B.P., Barenfeld, E., Öhlén, J. et al. Core outcomes for the evaluation of new healthcare programmes – a modified Delphi study. BMC Health Serv Res 25, 758 (2025). https://doi.org/10.1186/s12913-025-12897-1

Publications from GPCC studies:

Barenfeld E, Ekman I, Cederberg M, Fors A, Ali L, Gyllensten H.Patient and healthcare professional engagement and time use within a randomised controlled trial: investigating intervention costs associated with remote person-centred care in Sweden. BMJ Open. 2025 Oct 9;15(10):e099034. 

Harvey BP, Barenfeld E, Fors A, Ekman I, Swedberg K, Gyllensten H. Economic evaluation of a person-centred care intervention with a digital platform and structured telephone support for people with chronic heart failure and/or chronic obstructive pulmonary disease: results from a randomised controlled trial in Sweden. BMJ Open. 2025 Oct 9;15(10):e093083. 

Jabbar SA, Frödin M, Wikström E, Gillespie BM, Gyllensten H, Erichsen A. An economic evaluation of a hospital-wide bundle intervention to reduce hospital-acquired infections and bladder distension among hip fracture patients in Sweden. Antimicrob Resist Infect Control. 2025 Jul 3;14(1):80.

Kebede TT, Cederberg M, Alsén S, Fors A, Gyllensten H. A Person-Centered eHealth Intervention for Patients With Common Mental Disorders: Cost-Effectiveness Analysis Within a Randomized Controlled Trial. Value Health. 2025 Jun;28(6):875-883.

Gyllensten H, Larsson A, Bergenheim A, Barenfeld E, Mannerkorpi K. Physical activity with person-centered guidance supported by a digital platform or with telephone follow-up for persons with chronic widespread pain: Health economic considerations along a randomized controlled trial. Scand J Pain. 2024 May 7;24(1).

Blanck E, Pirhonen Nørmark L, Fors A, Ekman I, Ali L, Swedberg K, Gyllensten H. Self-efficacy and healthcare costs in patients with chronic heart failure or chronic obstructive pulmonary disease. ESC Heart Fail. 2024 Feb;11(1):219-228. 

Gyllensten H, Tistad M, Fridberg H, Wallin L. Analysis on personnel costs and working time for implementing a more person-centred care approach: a case study with embedded units in a Swedish region. BMJ Open. 2023 Oct 11;13(10):e073829

Gyllensten H, Haby K, Berg M, Premberg Å. Cost effectiveness of a controlled lifestyle intervention for pregnant women with obesity. BMC Pregnancy Childbirth. 2021 Sep 21;21(1):639.

Pirhonen L, Gyllensten H, Hansson Olofsson E, Fors A, Ali L, Ekman I, Bolin K. The cost-effectiveness of person-centred care provided to patients with chronic heart failure and/or chronic obstructive pulmonary disease. HP Open 2020;1:100005.

Pirhonen L, Gyllensten H, Fors A, Bolin K. Modelling the cost-effectiveness of person-centred care for patients with acute coronary syndrome. Eur J Health Econ. 2020 Dec;21(9):1317-1327.

Pirhonen L, Bolin K, Olofsson EH, Fors A, Ekman I, Swedberg K, Gyllensten H. Person-Centred Care in Patients with Acute Coronary Syndrome: Cost-Effectiveness Analysis Alongside a Randomised Controlled Trial. Pharmacoecon Open. 2019 Dec;3(4):495-504.

Gyllensten H, Koinberg I, Carlström E, Olsson LE, Hansson Olofsson E. Economic evaluation of a person-centred care intervention in head and neck oncology: results from a randomized controlled trial. Support Care Cancer. 2019 May;27(5):1825-1834.

Hansson E, Ekman I, Swedberg K, Wolf A, Dudas K, Ehlers L, Olsson LE. Person-centred care for patients with chronic heart failure - a cost-utility analysis. Eur J Cardiovasc Nurs. 2016 Jun;15(4):276-84.

Olsson LE, Hansson E, Ekman I, Karlsson J. A cost-effectiveness study of a patient-centred integrated care pathway. J Adv Nurs. 2009 Aug;65(8):1626-35.