Reducing the global burden of depression : population level analysis of intervention cost-effectiveness in 14 world regions

International evidence on the cost and effects of interventions for reducing the global burden of depression remain scarce. Aims: To estimate the population-level cost-effectiveness of evidence-based depression interventions and their contribution towards reducing current burden. Method: Primary-care-based depression interventions were modelled at the level of whole populations in 14 epidemiological subregions of the world. Total population-level costs (in international dollars or I$) and effectiveness (disability adjusted life years (DALYs) averted) were combined to form average and incremental cost-effectiveness ratios. Results: Evaluated interventions have the potential to reduce the current burden of depression by 10–30%. Pharmacotherapy with older antidepressant drugs, with or without proactive collaborative care, are currently more cost-effective strategies than those using newer antidepressants, particularly in lower-income subregions. Conclusions: Even in resource-poor regions, each DALYaverted by efficient depression treatments in primary care costs less than 1 year of average per capita income, making such interventions a cost-effective use of health resources. However, current levels of burden can only be reduced significantlyif there is a substantialincrease substantial increase intreatment coverage.

Survey design: Insights from a public sector ERP success story

Research on the impact of Information Systems (IS) reported in both academic literature and popular press has reported confounding results. Some studies have reported encouraging results of IS, while others have reported nil or detrimental results. The contradictory results of these research studies can be partially attributed to the weaknesses in survey instruments. In an attempt to increase the validity of conclusions of IS assessment studies, survey instrument design should follow a rigorous and scientific procedure. This paper illustrates key validity and reliability issues in measuring Information Systems performance, using examples from a study designed to assess Enterprise Resource Planning systems success. The article emphasizes on the importance of the survey method and the theoretical considerations of item derivation, scale development and item evaluation. Examples are provided from the ERP assessment study to supplement the readers understanding of the theoretical concepts of survey design.