Markov Models in health care

Sato, Renato Cesar; Zouain, Desirée Moraes

doi:10.1590/s1679-45082010rb1567

Cited by 26 publications

(18 citation statements)

References 14 publications

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“…As a model alternative in health economic evaluation, the Markov model can deal with more complex decision problems and is able to be applied for longer pathways/sequences, particularly for recurrent outcomes (Stahl, 2008;Sato and Zouain, 2010). Markov state refers patients are staying in one health state and can move from their current state to another state over discrete time period.…”

Section: Markov Modelmentioning

confidence: 99%

“…Sometimes, when it is intended to input parameters such as transition probabilities, for instance from systematic reviews, the confusion between "rate" and "probability" exists. Transition probabilities gathered from literature reviews do not exactly reflect the model's cycle that we construct (Sato, 2010). Rates are potential occurrence of an event in defined population and defined time.…”

Section: Figure 3 Markov Modelfor Cost-utility Analysis Of Veraniclimentioning

confidence: 99%

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Application of Decision Analytic Model in Health Economic Evaluation: Smoking Cessation Cases

Putri¹

2016

jurnaleki

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Health economic evaluation that encompasses decision analytic model is a beneficial approach for assisting decision maker to choose the best health intervention for patients. Decision analytic model has been increasingly applied in health economic evaluation. This mathematical approach is mostly used for conducting cost-effectiveness of healthcare interventions.Decision tree and Markov model has been widely applied in the past 20 years. Decision tree is the simplest form of decision model that drawn by the series of branches and clear pathways. Meanwhile, Markov model is one of the powerful approaches that employ stochastic process in health economic evaluation. This paper describes the applications of those two models in tobacco cessations, specifically for pharmacological interventions.First, decision tree for cost-effectiveness of smoking cessation program with pharmacist and therapies interventions compared to no program or self-aid cessation. Second, the application of Markov model estimates cost-effectiveness of veranicline, in comparison to bupropion. Markov model is constructed with morbidity and mortality states that consists of: well/no morbidities, lung cancer, COPD, stroke, myocardial infarction, and dead. This paper provides step by step of populating and constructing the model-with some modification of data. Several sections discuss the understanding of transition probabilities, costs data, cohort simulation, and the role of sensitivity analysis. Other models, despite deterministic approach, probabilistic approach are also reviewed.Both of models had both advantages and limitation that analysts should be aware of. Translating the ‘real world’ to mathematical model yields beneficial and insightful information for analysts. In addition, it could fulfill the need of evidence-based policy by decision maker. From simulation, the model may easy to be replicated-with appropriate context to generate evidence related health and costs.

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Section: Markov Modelmentioning

confidence: 99%

Section: Figure 3 Markov Modelfor Cost-utility Analysis Of Veraniclimentioning

confidence: 99%

Application of Decision Analytic Model in Health Economic Evaluation: Smoking Cessation Cases

Putri¹

2016

jurnaleki

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“…The fundamentals of our model are based on queuing theory and Markov's chains, since Markov models suppose the patients in a discrete state of health, and the events may represent the transition from one state to another. Furthermore, these approaches allow to model repetitive events and time dependence of probabilities [26]. So, we assume that events arrive to the system according to a homogeneous Poisson process with rate λ and to be consistent with an exponential distribution.…”

Section: B Mathematical Model For Dimensioning the Event-based Systemmentioning

confidence: 99%

A model for dimensioning a secure event-driven health care system

Sánchez-Guerrero

Almenárez

Díaz-Sánchez

et al. 2012

2012 5th Joint IFIP Wireless and Mobile Networking Conference (WMNC)

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Privacy is close to the user information and thus, present in any ubiquitous computing scenario. In this sense, privacy in identity management is gaining more importance, since IdM systems deal with services that requires sharing attributes belonging to users' identity with different entities across security domains. However, the effective revocation consent -considered as a privacy rule in sensitive scenarios-has not been fully addressed. This article builds on the flexible event-based user consentrevocation mechanism defined in [4] for health care scenarios. In this article we analyze the network dimensioning to calculate the overhead of activating/deactivating attributes and privileges, as subscription and notification event messages exchanged. We consider two main simulation scenarios: a large hospital, and a small-medium hospital.

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“…To handle this growing demand, economic analysis tools can be applied to new healthcare technologies to support decision-making in public health that aims for rational and efficient use of available resources [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Markov models have been widely used to evaluate new technologies and to compare healthcare strategies around the world. In comparing two strategies, the Markovian model provides the Incremental Cost-Effectiveness Ratio (ICER) as the primary result [8]. This ratio shows the additional cost required to save 1 year of life (adjusted or not by quality of life) using one strategy compared to a baseline strategy.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Primary and Secondary Prevention Strategies for Cervical Cancer in Brazil: A Systematic Review

Fonseca¹

2013

Gynecol Obstet

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BackgroundAlthough Cervical Cancer (CC) can be effectively prevented, almost 500,000 new cases are diagnosed each year worldwide [1]. The global reduction in the incidence and mortality from CC over the last four decades did not occur in a homogeneous manner; it was concentrated in the developed countries that were able to implement solid and effective population screening programs [2].In Brazil, organizational and financial difficulties have compromised the quality of prevention programs based on Oncotic Cytology (OC), and they have not succeeded in controlling the disease ; approximately 17,500 new cases of CC are expected in 2013 [3][4][5]. It is the second most common type of neoplasia in women (excluding non-melanoma skin cancer), and it is the type of neoplasia that claims the most lives of young women (15 to 44 years of age) [1].These difficulties, which are associated with the inherent limitations of the OC technique, have led many researchers to seek alternative or supplementary techniques for OC for CC screening, such as the hybrid capture test (HPV-DNA), and, more recently, to prepare vaccines against the most carcinogenic genotypes of HPV. These new technologies exhibit better performance and/or effectiveness; however, they would result in higher costs if they were incorporated into Brazil's prevention strategy.Because of the universal increase in healthcare costs and the growing constraints imposed by the scarcity of resources, there is a greater need to justify the use of a new technique by considering its cost-effectiveness ratio [6]. To handle this growing demand, economic analysis tools can be applied to new healthcare technologies to support decision-making in public health that aims for rational and efficient use of available resources [7,8].Among the methods of economic evaluation, cost-effectiveness analyses have received special attention [7]. Markov models have been widely used to evaluate new technologies and to compare healthcare strategies around the world. In comparing two strategies, the Markovian model provides the Incremental Cost-Effectiveness Ratio (ICER) as the primary result [8]. This ratio shows the additional cost required to save 1 year of life (adjusted or not by quality of life) using one strategy compared to a baseline strategy. The World Health Organization stipulates that a strategy is considered cost-effective if the AbstractBackground: Although Cervical Cancer (CC) can be effectively prevented, it is still a serious public health problem, especially in developing countries. In Brazil, almost 18,000 new cases are expected in 2013, and it is the type of neoplasia that claims the most lives of young women. New secondary prevention strategies (such as the HPV-DNA test) and primary prevention strategies (vaccination against HPV) have been developed. However, applying these strategies to large populations is costly, and their use is limited in Brazil. Because financial resources are scarce in Brazilian scenario, studies about the economic implications of the new preventativ...

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Markov Models in health care

Cited by 26 publications

References 14 publications

Application of Decision Analytic Model in Health Economic Evaluation: Smoking Cessation Cases

Application of Decision Analytic Model in Health Economic Evaluation: Smoking Cessation Cases

A model for dimensioning a secure event-driven health care system

Cost-Effectiveness of Primary and Secondary Prevention Strategies for Cervical Cancer in Brazil: A Systematic Review

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