Changing Health-Related Behaviors 2: On Improving the Value of Health Spending

Dickson, Karen R.; Wilson, Robert J.; Parfrey, Owen; Parfrey, Patrick S.

doi:10.1007/978-1-0716-1138-8_30

Cited by 1 publication

(1 citation statement)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…56 The bloated healthcare costs observed in the United States are due to a multitude of complex and interrelated issues. One of the contributors is the tendency for the medical community to favor more expensive interventions, assuming superior health benefit and effectiveness 44,57,58 ; a main criticism of this justification is the lack of supporting evidence. 58 Additionally, the OECD estimates that the United Kingdom 2021 healthcare costs account for 11.9% of the GDP, slightly above the European average of 9.9%, which has been rising annually.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Bankart repair versus nonoperative management for first-time anterior shoulder instability: A cost-effectiveness analysis

Li,

Hurley,

Garra

et al. 2023

Shoulder & Elbow

View full text Add to dashboard Cite

Purpose Arthroscopic Bankart repair (ABR) may be more effective than nonoperative management for patients with anterior shoulder instability following first-time dislocation. The purpose of the study was to determine the most cost-effective treatment strategy by evaluating the incremental cost-effectiveness ratio (ICER) for ABR versus nonoperative treatment. Methods This cost-effectiveness study utilized a Markov decision chain and Monte Carlo simulation. Probabilities, health utility values, and outcome data regarding ABR and nonoperative management of first-time shoulder instability derived from level I/II evidence. Costs were tabulated from Centers for Medicaid & Medicare Services. Probabilistic sensitivity analysis was performed using >100,000 repetitions of the Monte Carlo simulation. A willingness-to-pay (WTP) threshold was set at $50,000. Results The expected cost for operative management higher than nonoperative management ($32,765 vs $29,343). However, ABR (5.48 quality-adjusted life years (QALYs)) was the more effective treatment strategy compared to nonoperative management (4.61 QALYs). The ICER for ABR was $3943. Probabilistic sensitivity analysis showed that ABR was the most cost-effective strategy in 100% of simulations. Discussion ABR is more cost-effective than nonoperative management for first-time anterior shoulder dislocation. The threshold analysis demonstrated that when accounting for WTP, ABR was found to be the more cost-effective strategy.

show abstract

Section: Discussionmentioning

confidence: 99%