Devi Sridhar
- Published in print:
- 2008
- Published Online:
- January 2009
- ISBN:
- 9780199549962
- eISBN:
- 9780191720499
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199549962.003.0004
- Subject:
- Political Science, International Relations and Politics, Political Economy
This chapter describes how hunger is addressed by the Bank nutrition team. It examines the interlacing of economic ideology and politics in World Bank nutrition policy through focusing on the periods ...
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This chapter describes how hunger is addressed by the Bank nutrition team. It examines the interlacing of economic ideology and politics in World Bank nutrition policy through focusing on the periods 1971-1980, 1980-1993, and 1993-2006. It concludes that undernutrition is constructed as a matter of choice for households.Less
This chapter describes how hunger is addressed by the Bank nutrition team. It examines the interlacing of economic ideology and politics in World Bank nutrition policy through focusing on the periods 1971-1980, 1980-1993, and 1993-2006. It concludes that undernutrition is constructed as a matter of choice for households.
Judith Bosmans, Martijn Heymans, Maarten Hupperets, and Maurits van Tulder
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199561629
- eISBN:
- 9780191722479
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199561629.003.015
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Next to preventing injuries, it is of increasing interest to have some idea on the cost aspects of injuries and the prevention thereof. What does an injury cost in terms of direct medical costs and ...
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Next to preventing injuries, it is of increasing interest to have some idea on the cost aspects of injuries and the prevention thereof. What does an injury cost in terms of direct medical costs and indirect (e.g. work absenteeism) costs? Additionally, how much can be saved when injuries are prevented, taking into account that preventive measures have certain costs attached as well? This chapter focuses on this relatively new concept for sports injury research and provides background for gathering and analyzing cost data related to sports injury (prevention).Less
Next to preventing injuries, it is of increasing interest to have some idea on the cost aspects of injuries and the prevention thereof. What does an injury cost in terms of direct medical costs and indirect (e.g. work absenteeism) costs? Additionally, how much can be saved when injuries are prevented, taking into account that preventive measures have certain costs attached as well? This chapter focuses on this relatively new concept for sports injury research and provides background for gathering and analyzing cost data related to sports injury (prevention).
M. Barton Waring
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199573349
- eISBN:
- 9780191721946
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199573349.003.0004
- Subject:
- Business and Management, Public Management, Pensions and Pension Management
Unless defined benefit pension plans are managed much better and more cost-effectively, they will be replaced by defined contribution plans. Benefit and contribution policies need to be carefully ...
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Unless defined benefit pension plans are managed much better and more cost-effectively, they will be replaced by defined contribution plans. Benefit and contribution policies need to be carefully evaluated to make sure that a reasonable level of ongoing contributions, together with investment income, are adequate to fund the defined benefit plan without unpleasant surprises. Unless valuation and contribution conventions change to market-valued economically based quantities, decision makers will lack the right information with which to make informed policy decisions.Less
Unless defined benefit pension plans are managed much better and more cost-effectively, they will be replaced by defined contribution plans. Benefit and contribution policies need to be carefully evaluated to make sure that a reasonable level of ongoing contributions, together with investment income, are adequate to fund the defined benefit plan without unpleasant surprises. Unless valuation and contribution conventions change to market-valued economically based quantities, decision makers will lack the right information with which to make informed policy decisions.
Diana B. Petitti
- Published in print:
- 1999
- Published Online:
- September 2009
- ISBN:
- 9780195133646
- eISBN:
- 9780199863761
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195133646.003.12
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter introduces more advanced methods used in conduct of cost-effectiveness analyses that are built on the results of decision analysis. It describes the main types of cost analysis used to ...
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This chapter introduces more advanced methods used in conduct of cost-effectiveness analyses that are built on the results of decision analysis. It describes the main types of cost analysis used to evaluate health programs, discusses the reasons why cost-benefit analysis is rarely done in health care, and gives the rationale for the focus in medicine and health on cost-effectiveness and cost-utility analysis. The distinction between the average and marginal cost-effectiveness ratio is given. The chapter delineates the importance of perspective in cost-effectiveness analysis. It discusses the choice of time horizon and discount rate as key factors that affect cost-effectiveness analysis. It describes how cost should be measured ideally and how cost is most often measured in practice.Less
This chapter introduces more advanced methods used in conduct of cost-effectiveness analyses that are built on the results of decision analysis. It describes the main types of cost analysis used to evaluate health programs, discusses the reasons why cost-benefit analysis is rarely done in health care, and gives the rationale for the focus in medicine and health on cost-effectiveness and cost-utility analysis. The distinction between the average and marginal cost-effectiveness ratio is given. The chapter delineates the importance of perspective in cost-effectiveness analysis. It discusses the choice of time horizon and discount rate as key factors that affect cost-effectiveness analysis. It describes how cost should be measured ideally and how cost is most often measured in practice.
Amanda Killoran and Mike P. Kelly (eds)
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199563623
- eISBN:
- 9780191722554
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199563623.001.0001
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Evidence-Based Public Health: Effectiveness and Efficiency continues the themes raised in Public Health Evidence: tackling health inequalities. Written by the same team, this book is a ...
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Evidence-Based Public Health: Effectiveness and Efficiency continues the themes raised in Public Health Evidence: tackling health inequalities. Written by the same team, this book is a comprehensive reference to evidence-based approaches in public health. It covers the context and role of evidence-based public health in England; frameworks for evaluating the effectiveness and cost effectiveness of public health policies and interventions; diversity, vulnerability and risk as a focus for understanding the role of social context in influencing health-related behaviours; approaches and methods to generate and synthesize evidence of what works to improve health and tackle health inequalities; current best available evidence on the effectiveness of a diverse range of interventions; and the role of evidence-based guidance and standards in changing policy and practice.Less
Evidence-Based Public Health: Effectiveness and Efficiency continues the themes raised in Public Health Evidence: tackling health inequalities. Written by the same team, this book is a comprehensive reference to evidence-based approaches in public health. It covers the context and role of evidence-based public health in England; frameworks for evaluating the effectiveness and cost effectiveness of public health policies and interventions; diversity, vulnerability and risk as a focus for understanding the role of social context in influencing health-related behaviours; approaches and methods to generate and synthesize evidence of what works to improve health and tackle health inequalities; current best available evidence on the effectiveness of a diverse range of interventions; and the role of evidence-based guidance and standards in changing policy and practice.
Diana B. Petitti
- Published in print:
- 1999
- Published Online:
- September 2009
- ISBN:
- 9780195133646
- eISBN:
- 9780199863761
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195133646.001.0001
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This book is an introduction to three methods of quantitative synthesis—meta-analysis, decision analysis, and cost-effectiveness analysis. These methods are used widely to summarize information in ...
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This book is an introduction to three methods of quantitative synthesis—meta-analysis, decision analysis, and cost-effectiveness analysis. These methods are used widely to summarize information in order to guide the formulation of clinical recommendations and guidelines, and in clinical decision-making and health policy. The book gives step-by-step instructions on how to conduct studies that use each of the three methods, emphasizing the need for rigor. Important controversies about the statistical and mathematical theories that underlie the methods are highlighted, and key assumptions are identified. The methods are critically appraised and practices that should be avoided are identified. Despite the time that has elapsed between the last revision in 2000, the book remains a relevant and highly accessible source of information on how to conduct studies that use the three methods.Less
This book is an introduction to three methods of quantitative synthesis—meta-analysis, decision analysis, and cost-effectiveness analysis. These methods are used widely to summarize information in order to guide the formulation of clinical recommendations and guidelines, and in clinical decision-making and health policy. The book gives step-by-step instructions on how to conduct studies that use each of the three methods, emphasizing the need for rigor. Important controversies about the statistical and mathematical theories that underlie the methods are highlighted, and key assumptions are identified. The methods are critically appraised and practices that should be avoided are identified. Despite the time that has elapsed between the last revision in 2000, the book remains a relevant and highly accessible source of information on how to conduct studies that use the three methods.
Anupam B. Jena and Tomas J. Philipson
- Published in print:
- 2015
- Published Online:
- May 2016
- ISBN:
- 9780226254951
- eISBN:
- 9780226255002
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226255002.003.0011
- Subject:
- Law, Medical Law
This chapter reviews the role of cost-effective analysis (CEA) in treatment coverage determinations in the United States and discusses two important shortcomings of CEA. First, CEA can fail to ...
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This chapter reviews the role of cost-effective analysis (CEA) in treatment coverage determinations in the United States and discusses two important shortcomings of CEA. First, CEA can fail to allocate scarce resources in a way that is economically efficient because treatments that are equally valuable to society may have similar prices and yet cost society very different amounts to produce. Treatments of equal effectiveness and price will appear equally cost effective to insurers and government payers, even if from the perspective of society they are not. Companies therefore respond to the CEA by charging prices that maximize their profits, and health care spending rises. Second, basing coverage decisions only on a treatment's CEA can stifle innovation. Coverage policies based on cost effectiveness closely resemble price controls, which reduce incentives for innovation. Case studies from HIV/AIDS and cancer illustrate this. The chapter concludes by emphasizing the important role that the United States plays in determining global innovation incentives.Less
This chapter reviews the role of cost-effective analysis (CEA) in treatment coverage determinations in the United States and discusses two important shortcomings of CEA. First, CEA can fail to allocate scarce resources in a way that is economically efficient because treatments that are equally valuable to society may have similar prices and yet cost society very different amounts to produce. Treatments of equal effectiveness and price will appear equally cost effective to insurers and government payers, even if from the perspective of society they are not. Companies therefore respond to the CEA by charging prices that maximize their profits, and health care spending rises. Second, basing coverage decisions only on a treatment's CEA can stifle innovation. Coverage policies based on cost effectiveness closely resemble price controls, which reduce incentives for innovation. Case studies from HIV/AIDS and cancer illustrate this. The chapter concludes by emphasizing the important role that the United States plays in determining global innovation incentives.
Damian G. Walker, Philippe Beutels, and Raymond Hutubessy
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199547494
- eISBN:
- 9780191720055
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199547494.003.11
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
The last twenty years have seen an explosion in the number of new vaccines for children. This chapter identifies and discusses the factors that influence the cost-effectiveness of childhood vaccines, ...
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The last twenty years have seen an explosion in the number of new vaccines for children. This chapter identifies and discusses the factors that influence the cost-effectiveness of childhood vaccines, including the perspective of the evaluation, the time frame and analytic horizon, the discount rate, the choice of outcome measure, and the price per dose. It then considers some of the main challenges in undertaking economic evaluations of these technologies such as vaccination-specific costing issues and modeling the impact of vaccines. It discusses the use of cost-effectiveness evidence in immunization policy decision-making, and examines other criteria to consider when making such decisions.Less
The last twenty years have seen an explosion in the number of new vaccines for children. This chapter identifies and discusses the factors that influence the cost-effectiveness of childhood vaccines, including the perspective of the evaluation, the time frame and analytic horizon, the discount rate, the choice of outcome measure, and the price per dose. It then considers some of the main challenges in undertaking economic evaluations of these technologies such as vaccination-specific costing issues and modeling the impact of vaccines. It discusses the use of cost-effectiveness evidence in immunization policy decision-making, and examines other criteria to consider when making such decisions.
Peter J. Neumann
- Published in print:
- 2004
- Published Online:
- September 2009
- ISBN:
- 9780195171860
- eISBN:
- 9780199865345
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195171860.003.0007
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
The resistance to CEA highlighted in Chapters 3–6 suggests that the technique has had little impact. CEA might be characterized as an elegant but forbidden tool, beautifully made but outlawed as too ...
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The resistance to CEA highlighted in Chapters 3–6 suggests that the technique has had little impact. CEA might be characterized as an elegant but forbidden tool, beautifully made but outlawed as too dangerous. Still, the possibility remains that CEA actually enjoys considerable influence, not as an explicit instrument for prioritizing health services, but as a more subtle input into decision making. By the dawn of the 21st century, cost-effectiveness analysts had carved out a distinctive place in mainstream academic American medicine, even as the studies' impacts remained elusive. This chapter describes the possible influence of CEA generally and on major stakeholders, including Medicare, Medicaid, insurance companies, and pharmaceutical companies.Less
The resistance to CEA highlighted in Chapters 3–6 suggests that the technique has had little impact. CEA might be characterized as an elegant but forbidden tool, beautifully made but outlawed as too dangerous. Still, the possibility remains that CEA actually enjoys considerable influence, not as an explicit instrument for prioritizing health services, but as a more subtle input into decision making. By the dawn of the 21st century, cost-effectiveness analysts had carved out a distinctive place in mainstream academic American medicine, even as the studies' impacts remained elusive. This chapter describes the possible influence of CEA generally and on major stakeholders, including Medicare, Medicaid, insurance companies, and pharmaceutical companies.
Scott D. Grosse
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199547494
- eISBN:
- 9780191720055
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199547494.003.06
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Screening for metabolic, endocrine, and other diseases in newborns is performed through the laboratory analysis of dried blood spot specimens. This chapter reviews economic evaluations of newborn ...
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Screening for metabolic, endocrine, and other diseases in newborns is performed through the laboratory analysis of dried blood spot specimens. This chapter reviews economic evaluations of newborn dried blood spot screening strategies published during 2002-07, focusing on the cost-effectiveness of screening for cystic fibrosis, congenital adrenal hyperplasia, and medium chain acyl-CoA dehydrogenase deficiency (MCADD). The use of tandem mass spectrometry (MS/MS) to detect MCADD is presented in detail, through examinations of the costs of screening and medical management, and of outcomes, including quality-adjusted life year (QALY) measurement, disability, and mortality. Ways to generate higher quality evidence are presented. The chapter concludes with a discussion of the use of economic evaluations to inform newborn screening policies.Less
Screening for metabolic, endocrine, and other diseases in newborns is performed through the laboratory analysis of dried blood spot specimens. This chapter reviews economic evaluations of newborn dried blood spot screening strategies published during 2002-07, focusing on the cost-effectiveness of screening for cystic fibrosis, congenital adrenal hyperplasia, and medium chain acyl-CoA dehydrogenase deficiency (MCADD). The use of tandem mass spectrometry (MS/MS) to detect MCADD is presented in detail, through examinations of the costs of screening and medical management, and of outcomes, including quality-adjusted life year (QALY) measurement, disability, and mortality. Ways to generate higher quality evidence are presented. The chapter concludes with a discussion of the use of economic evaluations to inform newborn screening policies.
Ian Parry and Roberton C. Williams III
- Published in print:
- 2012
- Published Online:
- May 2012
- ISBN:
- 9780199692873
- eISBN:
- 9780191738371
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199692873.003.0010
- Subject:
- Economics and Finance, Development, Growth, and Environmental
This chapter estimates the welfare costs of the main medium‐term options for significantly reducing US energy‐related carbon dioxide (CO2) emissions, including carbon taxes and cap‐and‐trade systems ...
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This chapter estimates the welfare costs of the main medium‐term options for significantly reducing US energy‐related carbon dioxide (CO2) emissions, including carbon taxes and cap‐and‐trade systems applied economy‐wide and to the power sector only, and an emissions rate standard for power generation. The key theme is that welfare costs depend importantly on how policies interact with distortions in the economy created by the broader fiscal system. Economy‐wide cap‐and‐trade systems, or carbon taxes, where allowance rent or tax revenue is not used to increase economic efficiency, perform the worst on cost‐effectiveness grounds. In contrast, the costs of economy‐wide carbon taxes or auctioned allowance systems may be (slightly) negative, if revenues are used to substitute for distortionary income taxes (either directly, or indirectly through deficit reduction). The bottom line is that revenue/rents created under economy‐wide, market‐based carbon policies must be used to increase economic efficiency to ensure that these instruments are more cost‐effective than regulatory or sectoral approaches.Less
This chapter estimates the welfare costs of the main medium‐term options for significantly reducing US energy‐related carbon dioxide (CO2) emissions, including carbon taxes and cap‐and‐trade systems applied economy‐wide and to the power sector only, and an emissions rate standard for power generation. The key theme is that welfare costs depend importantly on how policies interact with distortions in the economy created by the broader fiscal system. Economy‐wide cap‐and‐trade systems, or carbon taxes, where allowance rent or tax revenue is not used to increase economic efficiency, perform the worst on cost‐effectiveness grounds. In contrast, the costs of economy‐wide carbon taxes or auctioned allowance systems may be (slightly) negative, if revenues are used to substitute for distortionary income taxes (either directly, or indirectly through deficit reduction). The bottom line is that revenue/rents created under economy‐wide, market‐based carbon policies must be used to increase economic efficiency to ensure that these instruments are more cost‐effective than regulatory or sectoral approaches.
Iqbal Dhaliwal, Esther Duflo, Rachel Glennerster, and Caitlin Tulloch
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780226078687
- eISBN:
- 9780226078854
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226078854.003.0008
- Subject:
- Education, Educational Policy and Politics
This chapter discusses how comparative cost-effectiveness analyses can help inform policy in developing countries and the underlying methodological assumptions necessary for performing this kind of ...
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This chapter discusses how comparative cost-effectiveness analyses can help inform policy in developing countries and the underlying methodological assumptions necessary for performing this kind of analysis. The chapter does not suggest a single set of “correct” assumptions, because the assumptions adopted in a cost-effectiveness analysis should reflect the perspective of the intended user. Rather, it discusses the issues surrounding many of these assumptions, such as what discount rate to use or whether to include cash transfers as program costs, and make recommendations on which assumptions might be reasonable given the perspective of a policymaker allocating resources between different projects. Examples are drawn from the education field to illustrate key issues and focus on specific applications to education. The hope is that this chapter will contribute to the development of a more standard methodology for cost-effectiveness analyses and a better understanding of how these analyses can be created and used.Less
This chapter discusses how comparative cost-effectiveness analyses can help inform policy in developing countries and the underlying methodological assumptions necessary for performing this kind of analysis. The chapter does not suggest a single set of “correct” assumptions, because the assumptions adopted in a cost-effectiveness analysis should reflect the perspective of the intended user. Rather, it discusses the issues surrounding many of these assumptions, such as what discount rate to use or whether to include cash transfers as program costs, and make recommendations on which assumptions might be reasonable given the perspective of a policymaker allocating resources between different projects. Examples are drawn from the education field to illustrate key issues and focus on specific applications to education. The hope is that this chapter will contribute to the development of a more standard methodology for cost-effectiveness analyses and a better understanding of how these analyses can be created and used.
Wendy J. Ungar
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199547494
- eISBN:
- 9780191720055
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199547494.003.07
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter is divided into three parts. The first part commences with a review of economic evaluations in child protection, including preventive and treatment interventions for physical abuse, ...
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This chapter is divided into three parts. The first part commences with a review of economic evaluations in child protection, including preventive and treatment interventions for physical abuse, sexual abuse, and neglect. It then describes the need for methodological improvements in economic evaluation of child protection to include inter-generational effects and recognize unique aspects, such as circular causal pathways, impacts that extend beyond the individual, and cross portfolio impacts. Part 1 examines the internal and external validity of effectiveness evidence and quality of life effects in harm prevention and ends with a discussion of policy relevance. The second part is a detailed discussion of economic evaluation of US welfare reform initiatives aimed at protecting children from parental abuse and neglect. This part addresses the measurement of outcomes in child welfare program innovation, including changes in services, accelerated permanency, health and safety, and changes in children's health outcomes as measured by school performance and delinquency. Part 2 concludes with suggestions for facilitating the conduct of economic analysis of welfare reforms. The third part of this chapter focuses on Fetal Alcohol Spectrum Disorder (FASD). After a brief review of screening, diagnosis and treatment for FASD, it summarizes current evidence regarding the economic burden and cost-effectiveness of FASD treatment and prevention.Less
This chapter is divided into three parts. The first part commences with a review of economic evaluations in child protection, including preventive and treatment interventions for physical abuse, sexual abuse, and neglect. It then describes the need for methodological improvements in economic evaluation of child protection to include inter-generational effects and recognize unique aspects, such as circular causal pathways, impacts that extend beyond the individual, and cross portfolio impacts. Part 1 examines the internal and external validity of effectiveness evidence and quality of life effects in harm prevention and ends with a discussion of policy relevance. The second part is a detailed discussion of economic evaluation of US welfare reform initiatives aimed at protecting children from parental abuse and neglect. This part addresses the measurement of outcomes in child welfare program innovation, including changes in services, accelerated permanency, health and safety, and changes in children's health outcomes as measured by school performance and delinquency. Part 2 concludes with suggestions for facilitating the conduct of economic analysis of welfare reforms. The third part of this chapter focuses on Fetal Alcohol Spectrum Disorder (FASD). After a brief review of screening, diagnosis and treatment for FASD, it summarizes current evidence regarding the economic burden and cost-effectiveness of FASD treatment and prevention.
E. J. Milner-Gulland and Marcus Rowcliffe
- Published in print:
- 2007
- Published Online:
- January 2008
- ISBN:
- 9780198530367
- eISBN:
- 9780191713095
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198530367.003.0007
- Subject:
- Biology, Biodiversity / Conservation Biology
This chapter looks at how to implement management plans, monitor their conservation effectiveness and value for money, and ensure that they are resilient for the long term. Effective decision-making ...
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This chapter looks at how to implement management plans, monitor their conservation effectiveness and value for money, and ensure that they are resilient for the long term. Effective decision-making requires information on the state of the system, and cost effective ways of monitoring are discussed, including participatory monitoring. However, even with good information, some uncertainty about the system will always remain, and decisions must be made in the face of this. Methods of dealing with uncertainty through decision analysis are discussed, and placed in the context of adaptive management, in which the outcomes of management actions are used to learn about the system. Finally, external threats are discussed, considering ways to buffer against changes in the ecological, economic, and institutional context that are beyond control.Less
This chapter looks at how to implement management plans, monitor their conservation effectiveness and value for money, and ensure that they are resilient for the long term. Effective decision-making requires information on the state of the system, and cost effective ways of monitoring are discussed, including participatory monitoring. However, even with good information, some uncertainty about the system will always remain, and decisions must be made in the face of this. Methods of dealing with uncertainty through decision analysis are discussed, and placed in the context of adaptive management, in which the outcomes of management actions are used to learn about the system. Finally, external threats are discussed, considering ways to buffer against changes in the ecological, economic, and institutional context that are beyond control.
Peter J. Neumann
- Published in print:
- 2004
- Published Online:
- September 2009
- ISBN:
- 9780195171860
- eISBN:
- 9780199865345
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195171860.003.0010
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
To some extent the problems confronting CEA are methodological ones. Users need reassurance not only that analyses are conceptually consistent but also that the measurement techniques underlying them ...
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To some extent the problems confronting CEA are methodological ones. Users need reassurance not only that analyses are conceptually consistent but also that the measurement techniques underlying them are valid. Though a full treatment of methodological advances is beyond the scope of this book, some important areas are highlighted in this chapter. Some of the issues discussed are costs, randomized controlled trials, modelling in CEAs, and communication in CEAs.Less
To some extent the problems confronting CEA are methodological ones. Users need reassurance not only that analyses are conceptually consistent but also that the measurement techniques underlying them are valid. Though a full treatment of methodological advances is beyond the scope of this book, some important areas are highlighted in this chapter. Some of the issues discussed are costs, randomized controlled trials, modelling in CEAs, and communication in CEAs.
Peter J. Neumann
- Published in print:
- 2004
- Published Online:
- September 2009
- ISBN:
- 9780195171860
- eISBN:
- 9780199865345
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195171860.001.0001
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
It is widely agreed that cost-effectiveness analysis (CEA) could shed light on ways for the U.S. health care system to achieve better value. However, to date American policy makers have largely ...
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It is widely agreed that cost-effectiveness analysis (CEA) could shed light on ways for the U.S. health care system to achieve better value. However, to date American policy makers have largely avoided using CEA and researchers have devoted little attention to understanding why this is so. By considering the economic, social, legal, and ethical factors that contribute to the situation, and how they can be negotiated in the future, this book offers a unique perspective. It traces the roots of CEA in health and medicine, describes its promise for rational resource allocation, and discusses the nature of the opposition to it, using Medicare and the Oregon health plan as examples. In exploring the disconnection between the promise of CEA and the persist failure of rational intentions, the book seeks to find common ground and practical solutions.Less
It is widely agreed that cost-effectiveness analysis (CEA) could shed light on ways for the U.S. health care system to achieve better value. However, to date American policy makers have largely avoided using CEA and researchers have devoted little attention to understanding why this is so. By considering the economic, social, legal, and ethical factors that contribute to the situation, and how they can be negotiated in the future, this book offers a unique perspective. It traces the roots of CEA in health and medicine, describes its promise for rational resource allocation, and discusses the nature of the opposition to it, using Medicare and the Oregon health plan as examples. In exploring the disconnection between the promise of CEA and the persist failure of rational intentions, the book seeks to find common ground and practical solutions.
J. Mick Tilford and Ali I. Raja
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199547494
- eISBN:
- 9780191720055
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199547494.003.09
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Traumatic brain injury (TBI) is a major health problem worldwide and is often referred to as the ‘silent epidemic’. The uncertainty faced by clinicians in treating children with severe brain injuries ...
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Traumatic brain injury (TBI) is a major health problem worldwide and is often referred to as the ‘silent epidemic’. The uncertainty faced by clinicians in treating children with severe brain injuries is controversial with important clinical and social implications. This chapter weighs the costs and consequences of aggressive treatment of pediatric TBI. It is organized into three sections. First, the physiology and treatment of TBI in children is described. Second, a cost-effectiveness analysis evaluating technology improvement in the treatment of pediatric TBI is presented. This analysis incorporates quality-adjusted life years (QALYs) using published data on preference-weighted health outcomes for children with TBI. Finally, the implications and clinical policy relevance of the analysis are discussed and additional research that could inform clinical policy is outlined.Less
Traumatic brain injury (TBI) is a major health problem worldwide and is often referred to as the ‘silent epidemic’. The uncertainty faced by clinicians in treating children with severe brain injuries is controversial with important clinical and social implications. This chapter weighs the costs and consequences of aggressive treatment of pediatric TBI. It is organized into three sections. First, the physiology and treatment of TBI in children is described. Second, a cost-effectiveness analysis evaluating technology improvement in the treatment of pediatric TBI is presented. This analysis incorporates quality-adjusted life years (QALYs) using published data on preference-weighted health outcomes for children with TBI. Finally, the implications and clinical policy relevance of the analysis are discussed and additional research that could inform clinical policy is outlined.
Tessa Tan-Torres Edejer, Moses Aikins, Robert Black, Lara Wolfson, Raymond Hutubessy, and David B. Evans
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199547494
- eISBN:
- 9780191720055
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199547494.003.13
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
There are logistical and analytical challenges when conducting economic evaluations in the developing world, ranging from lack of data on costs to determining generalizability. This chapter describes ...
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There are logistical and analytical challenges when conducting economic evaluations in the developing world, ranging from lack of data on costs to determining generalizability. This chapter describes the WHO-CHOICE approach, a generalized form of cost-effectiveness analysis. By using the ‘null’ scenario which assumes an absence of interventions for treating or preventing a condition of interest, this method allows existing and new interventions to be analysed at the same time. Cost-effectiveness analysis for child health interventions are presented including oral rehydration therapy, case management for pneumonia, Vitamin A and zinc supplementation and fortification, provision of supplementary food during weaning with nutrition counseling, and measles vaccination using the WHO-CHOICE approach. Methods for costing interventions and assessing the population impact of the interventions are presented. Results are expressed in terms of cost per disability-adjusted life year (DALY) averted. The chapter concludes with a discussion of the value of the WHO-CHOICE approach to inform resource allocation.Less
There are logistical and analytical challenges when conducting economic evaluations in the developing world, ranging from lack of data on costs to determining generalizability. This chapter describes the WHO-CHOICE approach, a generalized form of cost-effectiveness analysis. By using the ‘null’ scenario which assumes an absence of interventions for treating or preventing a condition of interest, this method allows existing and new interventions to be analysed at the same time. Cost-effectiveness analysis for child health interventions are presented including oral rehydration therapy, case management for pneumonia, Vitamin A and zinc supplementation and fortification, provision of supplementary food during weaning with nutrition counseling, and measles vaccination using the WHO-CHOICE approach. Methods for costing interventions and assessing the population impact of the interventions are presented. Results are expressed in terms of cost per disability-adjusted life year (DALY) averted. The chapter concludes with a discussion of the value of the WHO-CHOICE approach to inform resource allocation.
Thomas Pogge
- Published in print:
- 2011
- Published Online:
- January 2011
- ISBN:
- 9780199739073
- eISBN:
- 9780199855872
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199739073.003.0004
- Subject:
- Philosophy, General
This chapter proposes and critically discusses a principle that sets priorities for international nongovernmental organizations (INGOs) in a world where their resources fall short dramatically of the ...
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This chapter proposes and critically discusses a principle that sets priorities for international nongovernmental organizations (INGOs) in a world where their resources fall short dramatically of the needs they seek to meet. Other things being equal, an INGO should govern its decision making about candidate projects by such rules and procedures as are expected to maximize its long‐run cost‐effectiveness, defined as the expected aggregate moral value of the projects it undertakes divided by the expected aggregate cost of these projects. Here, aggregate moral value, or harm protection, is the sum of the moral values of the harm reductions (and increases) these projects bring about for the individual persons they affect.Less
This chapter proposes and critically discusses a principle that sets priorities for international nongovernmental organizations (INGOs) in a world where their resources fall short dramatically of the needs they seek to meet. Other things being equal, an INGO should govern its decision making about candidate projects by such rules and procedures as are expected to maximize its long‐run cost‐effectiveness, defined as the expected aggregate moral value of the projects it undertakes divided by the expected aggregate cost of these projects. Here, aggregate moral value, or harm protection, is the sum of the moral values of the harm reductions (and increases) these projects bring about for the individual persons they affect.
Diana B. Petitti
- Published in print:
- 1999
- Published Online:
- September 2009
- ISBN:
- 9780195133646
- eISBN:
- 9780199863761
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195133646.003.17
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Having taken a position of advocacy for the use of the three synthesis methods in the first sixteen chapters, this chapter identifies the serious limitations of the methods both theoretical and ...
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Having taken a position of advocacy for the use of the three synthesis methods in the first sixteen chapters, this chapter identifies the serious limitations of the methods both theoretical and practical. It begins by discussing the limitations of systematic review and meta-analysis based on empiric studies of the quality, reproducibility, and predictive validity published up to the year 2000. The overall conclusion of the early literature—that studies using systematic review and meta-analysis were uneven in quality of conduct and reporting—has not changed in the interval since this book was published. The chapter goes on to define framing effects and the implications of the existence of framing effects for conclusions based on decision analysis. Criticisms of the use of QALYs in making clinical and policy decisions are delineated. League tables are described and their use is critiqued. The chapter ends by identifying the situations in which each method is most useful and the situations in which they may be misleading or wrong.Less
Having taken a position of advocacy for the use of the three synthesis methods in the first sixteen chapters, this chapter identifies the serious limitations of the methods both theoretical and practical. It begins by discussing the limitations of systematic review and meta-analysis based on empiric studies of the quality, reproducibility, and predictive validity published up to the year 2000. The overall conclusion of the early literature—that studies using systematic review and meta-analysis were uneven in quality of conduct and reporting—has not changed in the interval since this book was published. The chapter goes on to define framing effects and the implications of the existence of framing effects for conclusions based on decision analysis. Criticisms of the use of QALYs in making clinical and policy decisions are delineated. League tables are described and their use is critiqued. The chapter ends by identifying the situations in which each method is most useful and the situations in which they may be misleading or wrong.
