Cost-Effectiveness Analysis in Health : A Practical Approach

by Muennig, Peter

• ISBN13: 9780787995560
• ISBN10: 0787995568
• Edition: 2nd
• Format: Hardcover
• Copyright: 2007-11-09
• Publisher: Jossey-Bass

Summary

This second edition of Cost Effectiveness Analysis in Health reviews issues and methods of assessing health care technologies and related programs. It emphasizes methods to perform economic evaluations, such as cost-effectiveness and cost-benefit analysis; methods to assess efficacy, effectiveness, and safety of health care technologies; effectiveness research; and applications to clinical and public policy. The book provides in-depth discussion of the uses and conducting of cost-effectiveness analyses (CEAs) as decision-making aids in public health, health services, and medicine. It explores cost-effectiveness in the context of societal decision making for resource allocation purposes. Chapter topics include: Defining and explaining cost-effectiveness, principles of cost-effectiveness analysis, how to develop a research project, working with costs, probabilities and models, calculating life expectancy, working with health-related quality of life measures, calculating quality-adjusted life years, conducting a sensitivity analysis, preparing your study for publication, working with data, and finding the data you need.

Author Biography

Peter Muennig is an assistant professor at Columbia University. Previously, he directed the Program in Cost-Effectiveness and Outcomes at New School University, consulted for Health Canada and the Centers for Disease Control and Prevention (CDC), and was an assistant professor at the Sophie Davis School of Biomedical Education.

Table of Contents

List of Tables, Figures, and Exhibits	p. ix
Preface	p. xiii
The Author	p. xvi
Introduction to Cost-Effectiveness	p. 1
Overview	p. 1
Why Cost-Effectiveness Is Useful	p. 3
Elements of Cost-Effectiveness Analysis	p. 4
The Cost-Effectiveness Ratio	p. 8
Why Conduct Cost-Effectiveness Analysis?	p. 9
The Reference Case Analysis	p. 12
Cost-Effectiveness Analysis and Policy	p. 14
Principles of Cost-Effectiveness Analysis	p. 19
Overview	p. 19
The Perspective of a Cost-Effectiveness Analysis	p. 19
Capturing Costs	p. 22
Capturing Quality	p. 23
Interpreting the Cost-Effectiveness Ratio	p. 27
Types of Economic Analysis	p. 30
Developing a Research Project	p. 36
Overview	p. 36
Eight Steps to a Perfect Research Project	p. 36
Developing a Research Question	p. 38
Designing Your Analysis	p. 43
Working with Costs	p. 50
Overview	p. 50
Opportunity Costs	p. 51
Identifying Costs	p. 52
Micro-Costing and Gross Costing	p. 55
Getting Cost Data	p. 57
Using Diagnosis Codes	p. 59
Adjusting Costs	p. 60
Costs Associated with Pain and Suffering	p. 69
Assessing the "Relevancy" of Cost Data	p. 70
Other Cost Considerations	p. 71
Probabilities and Models	p. 75
Overview	p. 75
Probabilities	p. 75
Decision Analysis Models	p. 79
Calculating Life Expectancy	p. 87
Overview	p. 87
Hand-Calculating Years Gained	p. 88
Calculating Life Years Lost Using Markov Models	p. 92
Working with Health-Related Quality-of-Life Measures	p. 104
Overview	p. 104
Framework	p. 105
Deriving HRQL Scores	p. 108
Other Considerations and Reminders	p. 115
Using Disability-Adjusted Life Years	p. 116
Calculating QALYs	p. 117
Overview	p. 117
Using the Summation Method	p. 118
Using the Life Table Method	p. 119
Calculating Incremental Cost-Effectiveness	p. 132
Disability-Adjusted Life Year (DALY)	p. 136
Conducting a Sensitivity Analysis	p. 137
Overview	p. 137
One-Way Sensitivity Analysis	p. 139
Two-Way Sensitivity Analysis	p. 142
Analysis of Influence	p. 143
Monte Carlo Simulation	p. 143
Determining the Plausible Range of Each Variable	p. 147
Preparing Your Study for Publication	p. 149
Overview	p. 149
Content and Structure of Cost-Effectiveness Articles	p. 149
Introduction	p. 151
Methods	p. 151
Results	p. 153
Technical Appendix	p. 154
Working with Data	p. 155
Overview	p. 155
Review of Rates	p. 156
Understanding Error	p. 160
Managing Error in Cost-Effectiveness Analysis	p. 162
Calculating Weighted Means	p. 168
Evaluating Study Limitations	p. 170
Finding the Data You Need	p. 179
Overview	p. 179
Finding Data in the Medical Literature	p. 180
Grading Published Data	p. 180
Using Electronic Datasets	p. 180
Using Unpublished Data	p. 188
Using Data from Piggybacked Studies	p. 188
Using Expert Opinion	p. 189
Organizing Your Data	p. 189
Answer Key to Exercises	p. 191
Life Expectancy and Quality-Adjusted Life Expectancy Tables	p. 197
EuroQol Instrument and Weighting Scheme	p. 201
Diagnosis, Charges, Medicare Reimbursement, Average Length of Stay, and Cost-to-Charge Ratio by Diagnosis-Related Groups, 2004	p. 203
Glossary	p. 249
References	p. 255
Index	p. 259
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