Cost effectiveness

About: Cost effectiveness is a research topic. Over the lifetime, 69775 publications have been published within this topic receiving 1531477 citations.

Privacy, information technology, and health care

Abstract: W e are well into the digital information age. Digital communications and information resources affect almost every aspect of our lives— business, finance, education, government, and entertainment. Clinical medicine is highly information intensive, but it is one of the few areas of our society where computer access to information has had only limited success in selected areas such as billing and scheduling, laboratory result reporting, and diagnostic instrument systems (such as radiology and cardiology). The move to widely accepted electronic patient records (EPRs) is accelerating, however, and is inevitable because of many pressures. Among those pressures are the desire to improve health care through timely access to information and decision-support aids; the need for simultaneous access to records by doctors, nurses, and administrators in modern, integrated provider and referral systems; meeting the needs of highly mobile patients; the push toward improved cost effectiveness based on analyses of outcomes and utilization information; the need for better support of clinical research; and the growing use of telemedicine and telecare [5]. We are, of course, motivated by the great benefits to patient care and medicine that can derive from this effort. But almost daily we hear about network computer break-ins—often close to home—arousing vivid fears [4]. By putting our personal medical records online, might we be increasing the risk of exposing highly private and sensitive information to outsiders? In this article we take a systems view of privacy and information security in health care. We will put the nature of the most urgent threats to patient information privacy in perspective, the new threats that almost certainly will arise because of the technologies of digital information,

Agricultural Growth and Poverty Reduction: Additional Evidence

Abstract: Agricultural growth has long been recognized as an important instrument for poverty reduction. Yet, measurements of this relationship are still scarce and not always reliable. The authors present additional evidence at both the sectoral and household levels based on recent data. Results show that rural poverty reduction has been associated with growth in yields and in agricultural labor productivity, but that this relation varies sharply across regional contexts. Gross domestic product (GDP) growth originating in agriculture induces income growth among the 40 percent poorest, which is on the order of three times larger than growth originating in the rest of the economy. The power of agriculture comes not only from its direct poverty reduction effect but also from its potentially strong growth linkage effects on the rest of the economy. Decomposing the aggregate decline in poverty into a rural contribution, an urban contribution, and a population shift component shows that rural areas contributed more than half the observed aggregate decline in poverty. Finally, using the example of Vietnam, the authors show that rapid growth in agriculture has opened pathways out of poverty for farming households. While the effectiveness of agricultural growth in reducing poverty is well established, the effectiveness of public investment in inducing agricultural growth is still incomplete and conditional on context.

Cost-effectiveness Analysis of a Rotavirus Immunization Program for the United States

Abstract: Context.—Rotavirus is the most common cause of severe diarrhea in children, and a live, oral vaccine may soon be licensed for prevention.Objective.—To estimate the economic impact of a national rotavirus immunization program in the United States.Design.—Cost-effectiveness was analyzed from the perspectives of the health care system and society. A decision tree used estimates of disease burden, costs, vaccine coverage, efficacy, and price obtained from published and unpublished sources.Intervention.—The proposed vaccine would be administered to infants at ages 2, 4, and 6 months as part of the routine schedule of childhood immunizations.Main Outcome Measures.—Total costs, outcomes prevented, and incremental cost-effectiveness.Results.—A routine, universal rotavirus immunization program would prevent 1.08 million cases of diarrhea, avoiding 34000 hospitalizations, 95000 emergency department visits, and 227000 physician visits in the first 5 years of life. At $20 per dose, the program would cost $289 million and realize a net loss of $107 million to the health care system—$103 per case prevented. The program would provide a net savings of $296 million to society. Threshold analysis identified a break-even price per dose of $9 for the health care system and $51 for the societal perspective. Greater disease burden and greater vaccine efficacy and lower vaccine price increased cost-effectiveness.Conclusions.—A US rotavirus immunization program would be cost-effective from the perspectives of society and the health care system, although the cost of the immunization program would not be fully offset by the reduction in health care cost of rotavirus diarrhea unless the price fell to $9 per dose.