Journal ArticleDOI
Cost-effectiveness with multiple outcomes.
Jakob B. Bjorner,Hans Keiding +1 more
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TLDR
An approach to cost-effectiveness analysis where artificial aggregation is avoided is proposed, assigning to each activity the weights which are the most favourable in a comparison with the other options available, so that activities which have a poor score in this method are guaranteed to be inferior.Abstract:
In a large number of situations, activities in health care have to be measured in terms of outcome and cost. However, the cases where outcome is fully captured by a single measure are rather few, so that one uses some index for outcome, computed by weighing together several outcome measures using subjective and somewhat arbitrary weights. In the paper we propose an approach to cost-effectiveness analysis where such artificial aggregation is avoided. This is achieved by assigning to each activity the weights which are the most favourable in a comparison with the other options available, so that activities which have a poor score in this method are guaranteed to be inferior. The method corresponds to applying Data envelopment analysis, known from the theory of productivity, to the context of health economic evaluations. The method is applied to an analysis of the cost-effectiveness of alternative health plans using data from the Medical Outcome Study (JAMA 1996; 276: 1039-1047), where outcome is measured as improvement in mental and physical health.read more
Citations
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Challenges for performance assessment and improvement in primary health care: The case of the Portuguese health centres
TL;DR: From the empirical analysis, it is concluded that there is evidence of large variation in equity of access to services, in technical efficiency and quality of services across district health authorities.
Journal ArticleDOI
Cost‐effectiveness of educational outreach to primary care nurses to increase tuberculosis case detection and improve respiratory care: economic evaluation alongside a randomised trial
Lara Fairall,Max O Bachmann,Merrick Zwarenstein,Eric D. Bateman,Louis W. Niessen,Carl Lombard,Bosielo P Majara,René G English,Angeni Bheekie,Dingie van Rensburg,Pat Mayers,Annatjie C Peters,Ronald Chapman +12 more
TL;DR: An educational outreach intervention to improve primary respiratory care by South African nurses is evaluated to evaluate the cost‐effectiveness of this intervention.
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A research agenda for economic evaluation of substance abuse services.
TL;DR: In this article, the authors present background information on the economics of addiction health services, reviews recent empirical and methodological contributions, and provides 15 research recommendations for the next wave of research.
Journal ArticleDOI
The efficiency of government spending on health: Evidence from Europe and Central Asia
TL;DR: In this paper, the authors used data envelopment analysis (DEA) to evaluate health expenditures to demonstrate how productivity has changed over time for 46 selected countries in Europe and Central Asia.
Journal ArticleDOI
Better informing decision making with multiple outcomes cost-effectiveness analysis under uncertainty in cost-disutility space.
TL;DR: Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding transparent and robust joint comparison of costs and multiple effects under uncertainty across potential threshold values for effect, better informing net benefit assessment and related reimbursement and research decisions.
References
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Journal ArticleDOI
Measuring the efficiency of decision making units
TL;DR: A nonlinear (nonconvex) programming model provides a new definition of efficiency for use in evaluating activities of not-for-profit entities participating in public programs and methods for objectively determining weights by reference to the observational data for the multiple outputs and multiple inputs that characterize such programs.
Journal ArticleDOI
A procedure for ranking efficient units in data envelopment analysis
TL;DR: In this paper, a modified version of DEA based upon comparison of efficient DMUs relative to a reference technology spanned by all other units is developed, which provides a framework for ranking efficient units and facilitates comparison with rankings based on parametric methods.
Journal ArticleDOI
The Medical Outcomes Study. An application of methods for monitoring the results of medical care
Alvin R. Tarlov,John E. Ware,Sheldon Greenfield,Eugene C. Nelson,Edward B. Perrin,Michael Zubkoff +5 more
TL;DR: The Medical Outcomes Study was designed to determine whether variations in patient outcomes are explained by differences in system of care, clinician specialty, and clinicians' technical and interpersonal styles and develop more practical tools for the routine monitoring of patient outcomes in medical practice.
Journal ArticleDOI
Pulling cost-effectiveness analysis up by its bootstraps: a non-parametric approach to confidence interval estimation.
TL;DR: It is concluded that percentile bootstrap confidence interval methods provide a promising approach to estimating the uncertainty of ICER point estimates, however, successive bootstrap estimates of bias and standard error suggests that these may be unstable; accordingly, it is strongly recommend a cautious interpretation of such estimates.
Journal ArticleDOI
Differences in 4-year health outcomes for elderly and poor, chronically ill patients treated in HMO and fee-for-service systems. Results from the Medical Outcomes Study.
TL;DR: During the study period, elderly and poor chronically ill patients had worse physical health outcomes in HMOs than in FFS systems; mental health outcomes varied by study site and patient characteristics.
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