Cost effectiveness

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

The Effectiveness and Efficiency of Private Schools in Chile's Voucher System

Abstract: This paper assesses the relative effectiveness and efficiency of private and public schools in Chile, where the military government implemented a national voucher plan in 1980. Non-religious voucher schools (accounting for two-thirds of primary enrollments in all private voucher schools) are marginally less effective than public schools in producing academic achievement in the fourth grade; at best, they are similarly effective. Catholic voucher schools are somewhat more effective than public schools. Nevertheless, non-religious schools are more efficient, by virtue of producing academic achievement at a lower cost. The difference is probably attributable to lower teacher wages and constraints on public school resource allocation. The relative efficiency of public and Catholic schools is similar. We tentatively conclude that the case for shifting public resources to privately run schools is mixed (although a comprehensive evaluation would require evidence not provided by this research).

Cost-Effectiveness of Detecting and Treating Diabetic Retinopathy

Abstract: Objective : To determine, from the health insurer's perspective, the cost of preventing vision loss in patients with diabetes mellitus through ophthalmologic screening and treatment and to calculate the cost-effectiveness of these interventions as compared with that of other medical interventions. Design : Computer modeling, incorporating data from population-based epidemiologic studies and multicenter clinical trials. Monte Carlo simulation was used, combined with sensitivity analysis and present value analysis of cost savings. Results : Screening and treatment of eye disease in patients with diabetes mellitus costs $3190 per quality-adjusted life-year (QALY) saved. This average cost is a weighted average (based on prevalence of disease) of the cost-effectiveness of detecting and treating diabetic eye disease in those with insulin-dependent diabetes mellitus ($1996 per QALY), those with non-insulin-dependent diabetes mellitus (NIDDM) who use insulin for glycemic control ($2933 per QALY), and those with NIDDM who do not use insulin for glycemic control ($3530 per QALY). Conclusions : Our analysis indicates that prevention programs aimed at improving eye care for diabetic persons not only result in substantial federal budgetary savings but are highly cost-effective health investments for society. Ophthalmologic screening for diabetic persons is more cost-effective than many routinely provided health interventions. Because diabetic eye disease is the leading cause of new cases of blindness among working-age Americans, these results support the widespread use of screening and treatment for diabetic eye disease.

Integrating primary medical care with addiction treatment: a randomized controlled trial.

Abstract: ContextThe prevalence of medical disorders is high among substance abuse patients, yet medical services are seldom provided in coordination with substance abuse treatmentObjectiveTo examine differences in treatment outcomes and costs between integrated and independent models of medical and substance abuse care as well as the effect of integrated care in a subgroup of patients with substance abuse–related medical conditions (SAMCs)DesignRandomized controlled trial conducted between April 1997 and December 1998Setting and PatientsAdult men and women (n = 592) who were admitted to a large health maintenance organization chemical dependency program in Sacramento, CalifInterventionsPatients were randomly assigned to receive treatment through an integrated model, in which primary health care was included within the addiction treatment program (n = 285), or an independent treatment-as-usual model, in which primary care and substance abuse treatment were provided separately (n = 307) Both programs were group based and lasted 8 weeks, with 10 months of aftercare availableMain Outcome MeasuresAbstinence outcomes, treatment utilization, and costs 6 months after randomizationResultsBoth groups showed improvement on all drug and alcohol measures Overall, there were no differences in total abstinence rates between the integrated care and independent care groups (68% vs 63%, P = 18) For patients without SAMCs, there were also no differences in abstinence rates (integrated care, 66% vs independent care, 73%; P = 23) and there was a slight but nonsignificant trend of higher costs for the integrated care group ($36796 vs $32409, P = 19) However, patients with SAMCs (n = 341) were more likely to be abstinent in the integrated care group than the independent care group (69% vs 55%, P = 006; odds ratio [OR], 190; 95% confidence interval [CI], 122-297) This was true for both those with medical (OR, 338; 95% CI, 168-680) and psychiatric (OR, 210; 95% CI, 104-425) SAMCs Patients with SAMCs had a slight but nonsignificant trend of higher costs in the integrated care group ($47081 vs $42795, P = 14) The incremental cost-effectiveness ratio per additional abstinent patient with an SAMC in the integrated care group was $1581ConclusionsIndividuals with SAMCs benefit from integrated medical and substance abuse treatment, and such an approach can be cost-effective These findings are relevant given the high prevalence and cost of medical conditions among substance abuse patients, new developments in medications for addiction, and recent legislation on parity of substance abuse with other medical benefits

Evidence on the cost and cost-effectiveness of palliative care: A literature review:

Abstract: Background:In the context of limited resources, evidence on costs and cost-effectiveness of alternative methods of delivering health-care services is increasingly important to facilitate appropriate resource allocation. Palliative care services have been expanding worldwide with the aim of improving the experience of patients with terminal illness at the end of life through better symptom control, coordination of care and improved communication between professionals and the patient and family.Aim:To present results from a comprehensive literature review of available international evidence on the costs and cost-effectiveness of palliative care interventions in any setting (e.g. hospital-based, home-based and hospice care) over the period 2002–2011.Design:Key bibliographic and review databases were searched. Quality of retrieved papers was assessed against a set of 31 indicators developed for this review.Data Sources:PubMed, EURONHEED, the Applied Social Sciences Index and the Cochrane library of databases....