Equity and the economic evaluation of healthcare

Sassi, Franco; Archard, Luke; Grand, Julian Le

doi:10.3310/hta5030

Cited by 114 publications

(115 citation statements)

References 466 publications

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“…Dicker and Armstrong, 1995;Stronks et al, 1997;Cookson and Dolan, 1999). It was clear from the literature reviewed, and from previously published reviews (Sassi et al, 2001a;Schwappach, 2002a;Dolan et al, 2005), that some commonly cited considerations, e.g. age, desert/lifestyle, did not have strong empirical support as priority-setting criteria.…”

Section: Settingmentioning

confidence: 95%

“…However, there are often a range of social values that influence policy decisions, and when there are trade-offs across these social values, or equity arguments (objectives), judgments are needed on which things are better than others (referred to as 'betterness' by Broome, 1991). Reviews in the health-care literature have identified the need to investigate the relationship between key equity arguments (Sassi et al, 2001a;Schwappach, 2002a;Dolan et al, 2005). The findings presented in this paper provide a number of opportunities to weigh different social values against one another, in a policy-relevant context, and to consider which health technology scenarios are better than others, from the perspective of the social preferences elicited.…”

Section: Discussionmentioning

confidence: 99%

“…Recent reviews of the health-related literature around social values and distributive preferences have recommended that research is needed into the relationship (i.e. relative values) between key social values (Sassi et al, 2001a;Schwappach, 2002a;Hauck et al, 2003;Dolan et al, 2005). This paper presents findings from a study to elicit the preferences of the general public over scenarios describing health-care interventions against generic social value judgments.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the social value of health‐care interventions: a stated preference discrete choice experiment

2008

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SUMMARYMuch of the literature on distributive preferences covers specific considerations in isolation, and recent reviews have suggested that research is required to inform on the relative importance of various key considerations. Responding to this research recommendation, we explore the distributive preferences of the general public using a set of generic social value judgments. We report on a discrete choice experiment (DCE) survey, using face-to-face interviews, in a sample of the general population (n 5 259). The context for the survey was resource allocation decisions in the UK National Health Service, using the process of health technology appraisal as an example. The attributes used covered health improvement, value for money, severity of health, and availability of other treatments, and it is the first such survey to use cost-effectiveness in scenarios described to the general public. Results support the feasibility and acceptability of the DCE approach for the elicitation of public preferences. Choice data are used to consider the relative importance of changes across attribute levels, and to model utility scores and relative probabilities for the full set of combinations of attributes and levels in the experimental design used (n 5 64). Results allow the relative social value of health technology scenarios to be explored. Findings add to a sparse literature on 'social' preferences, and show that DCE data can be used to consider the strength of preference over alternative scenarios in a prioritysetting context.

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Section: Settingmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the social value of health‐care interventions: a stated preference discrete choice experiment

2008

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“…In other words, the algorithm does not distinguish between health gains to individuals i and j. Economists who allow for interpersonal comparisons of welfare typically aggregate benefits according to the sum-ranking rule, which, by implication, assumes linearity in all of the elements in Equation (2).…”

Section: Qaly Maximisationmentioning

confidence: 99%

QALY maximisation and people's preferences: a methodological review of the literature

et al. 2004

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SummaryIn cost-utility analysis, the numbers of quality-adjusted life years (QALYs) gained are aggregated according to the sum-ranking (or QALY maximisation) rule. This requires that the social value from health improvements is a simple product of gains in quality of life, length of life and the number of persons treated. The results from a systematic review of the literature suggest that QALY maximisation is descriptively flawed. Rather than being linear in quality and length of life, it would seem that social value diminishes in marginal increments of both. And rather than being neutral to the characteristics of people other than their propensity to generate QALYs, the social value of a health improvement seems to be higher if the person has worse lifetime health prospects and higher if that person has dependents. In addition, there is a desire to reduce inequalities in health. However, there are some uncertainties surrounding the results, particularly in relation to what might be affecting the responses, and there is the need for more studies of the general public that attempt to highlight the relative importance of various key factors. Copyright

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“…Los fondos son financiados por tres fuentes: Gobierno Federal, contribuyente corresponsable y el beneficiario 7 . Las intervenciones en salud Dado lo anterior, y en el actual contexto de reformas de sector salud, se plantea la necesidad de distribuir los recursos financieros eficientemente, mediante el establecimiento de patrones de asignación, de acuerdo con las demandas específicas de salud 9 , teniendo como hilo conductor la incorporación de las perspectivas económica, clínica y epidemiológica. Por ello, la evaluación económica de la producción de servicios de salud se plantea como uno de los problemas principales de la organización de los sistemas de salud 10,11,12 .…”

Section: Introductionunclassified

Análisis de costos de atención médica para esquizofrenia y depresión en México para el periodo 2005-2013

et al. 2018

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El objetivo fue identificar los costos de la atención para enfermedades de salud mental en el sistema de salud de México. Se trata de una investigación evaluativa de tipo transversal retrospectivo. Se seleccionaron como trazadores del problema dos de las principales demandas de salud mental en los últimos años: depresión y esquizofrenia. La incidencia acumulada anual se identificó a partir del reporte epidemiológico por tipo de institución para el periodo 2005-2013. El costo del manejo anual de caso promedio se determinó a partir de la técnica de instrumentación y consenso, identificando las funciones de producción, el tipo de insumos, los costos y cantidad de insumos requeridos, concentrados en la matriz de caso promedio. Finalmente, se aplicó un factor de ajuste econométrico para controlar efecto inflacionario para cada año del periodo de estudio. El costo promedio del manejo anual de un caso en dólares americanos para esquizofrenia fue de 2.216,00 y para depresión 2.456,00. Para todas las instituciones del sistema de salud se observan tendencias epidemiológicas y económicas crecientes y constantes. El costo total para ambas enfermedades para el último año del periodo (2013) fue de USD 39.081.234,00, USD 18.119.877,00 para esquizofrenia y USD 20.961.357,00 para depresión. El mayor impacto para ambas enfermedades está en las instituciones para población no asegurada (USD 24.852.321,00) vs. población asegurada (USD 12.891.977,00). El costo de satisfacer la demanda de servicios para ambas enfermedades difiere considerablemente entre las instituciones que se ocupan de la población asegurada vs. población no asegurada, siendo mayor el de las segundas. Los indicadores epidemiológicos y económicos de este estudio contribuyen a la generación de evidencias para tomar decisiones en el uso y asignación de recursos para los servicios de salud que demandarán ambas enfermedades en los próximos años.

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Equity and the economic evaluation of healthcare

Cited by 114 publications

References 466 publications

Exploring the social value of health‐care interventions: a stated preference discrete choice experiment

Exploring the social value of health‐care interventions: a stated preference discrete choice experiment

QALY maximisation and people's preferences: a methodological review of the literature

Análisis de costos de atención médica para esquizofrenia y depresión en México para el periodo 2005-2013

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