| 1. |
- Johannesson, Magnus, et al.
(författare)
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Advantages of using the net-benefit approach for analysing uncertainty in economic evaluation studies
- 2003
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Ingår i: PharmacoEconomics. - : Adis International. - 1179-2027 .- 1170-7690. ; 21:1, s. 39-48
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Tidskriftsartikel (refereegranskat)abstract
- No consensus has yet been reached on how to analyse uncertainty in economic evaluation studies where individual patient data are available for costs and health effects. This paper summarises the available results regarding the analysis of uncertainty on the cost-effectiveness plane and argues for using the net-benefit approach when analysing uncertainty in cost-effectiveness studies. The net-benefit approach avoids the interpretation and statistical problems related to the incremental cost effectiveness ratio and implies several advantages. First, traditional statistical methods can be used for confidence-interval estimation and hypothesis testing. Second, calculation of the optimal sample size and the power of the study are facilitated allowing the correlation between costs and effects to vary within and between patient groups. Third, the use of a Bayesian approach to cost-effectiveness analysis is facilitated. Fourth, a formal relation between cost-effectiveness acceptability curves and statistical inference is provided. Finally, the net-benefit approach gives the Fieller's limits of the confidence interval for the incremental cost-effectiveness ratio in the cost-effectiveness plane. Based on these advantages the net-benefit approach should strongly be considered when analysing uncertainty in cost-effectiveness analyses.
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| 2. |
- Tambour, Magnus, et al.
(författare)
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A Note on Confidence Intervals in Cost-Effectiveness Analysis
- 1998
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Ingår i: International journal of technology assessment in health care. - : Cambridge University Press. - 1471-6348 .- 0266-4623. ; 14:3, s. 467-471
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Tidskriftsartikel (refereegranskat)abstract
- How to obtain confidence intervals for cost-effectiveness ratios is complicated by the statistical problems of obtaining a confidence interval for a ratio of random variables. Different approaches have been suggested in the literature, but no consensus has been reached. We propose an alternative simple solution to this problem. By multiplying the effectiveness units by the price per effectiveness unit, both costs and benefits can be expressed in monetary terms and standard statistical techniques can be used to estimate a confidence interval for net benefits. This approach avoids the ratio estimation problem and explicitly recognizes that the price per effectiveness unit has to be known to provide cost-effectiveness analysis with a useful decision rule.
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| 3. |
- Zethraeus, Niklas, et al.
(författare)
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Value for money? A contingent valuation study of the optimal size of the Swedish health care budget
- 1995
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Ingår i: Health policy (Amsterdam). - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 34:2, s. 135-143
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Tidskriftsartikel (refereegranskat)abstract
- The contingent valuation method has been developed in the environmental field to measure the willingness to pay for environmental changes using survey methods. In this exploratory study the contingent valuation method was used to analyse how much individuals are willing to spend in total in the form of taxes for health care in Sweden, i.e. to analyse the optimal size of the ‘health care budget’ in Sweden. A binary contingent valuation question was included in a telephone survey of a random sample of 1260 households in Sweden. With a conservative interpretation of the data the result shows that 50% of the respondents would accept an increased tax payment to health care of about SEK 60 per month ($1 = SEK 8). It is concluded that the results indicate that the population overall thinks that the current spending on health care in Sweden is on a reasonable level. There seems to be a willingness to increase the tax payments somewhat, but major increases does not seem acceptable to a majority of the population.
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| 4. |
- Eckerlund, Ingemar, et al.
(författare)
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Benchmarking in obstetric care : a comparative study based on data envelopment analysis (DEA)
- 2001
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Benchmarking is increasingly used in performance monitoring of the health care sector, for self-assessment as well as external accountability - in order to promote efficiency. However, a prerequisite for achieving this objective is that the benchmarking process is based on scientifically sound methods. Using DRG-data from 19 Swedish hospitals in 1994-1995, we apply data envelopment analysis (DEA) to compare technical efficiency (productivity) of inpatient obstetric care. The results indicate an average potential for enhanced productivity of at least six-seven percent each year. Most hospitals show decreasing productivity between 1994 and 1995, partly due to their inability to adjust production capacity and costs to decreasing demand, From a policy perspective, DEA could be very useful in performance monitoring. An important advantage ofthe DEA method is that it helps identify the strengths and weaknesses of the various units (hospital departments) studied. We conclude that there are good reasons for adopting the DEA method for benchmarking in other types of hospital departments as well, and preferably on a larger scale, Le., with more observations, and also for including health outcome and quality indicators among the output variables.
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| 5. |
- Eckerlund, Ingemar, et al.
(författare)
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Change-oriented patient questionnaires : testing a new method at three departments of ophthalmology.
- 1997
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Ingår i: International journal of health care quality assurance incorporating Leadership in health services. - : MCB University Press. - 1366-0756. ; 10, s. 254-259
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The use of patient questionnaires has increased widely in recent years. Their purpose, to incorporate patient perspectives into the orientation and design of health care, is, of course, commendable. However, the survey methods themselves have been less adequate, both in terms of validity and reliability, and with respect to the potential for using the results to improve the quality of health care. Presents a pilot study at three departments of ophthalmology in Sweden, involving a new method which meets reasonable demands for validity and reliability, and is explicitly change-oriented.
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| 6. |
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| 7. |
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| 8. |
- Tambour, Magnus, et al.
(författare)
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Productivity and customer satisfaction in Swedish pharmacies : A DEA network model
- 1999
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Ingår i: European Journal of Operational Research. - : Elsevier. - 0377-2217. ; 115:3, s. 449-458
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This paper presents a Data Envelopment Analysis (DEA) network model that allows inclusion of customer satisfaction in efficiency and productivity measures. The network consists of a production node and a consumption node and offers flexibility in modelling the production and consumption process where a firm-specific allocation of input resources to production and customer oriented activities is allowed. The proposed model is applied on a sample of Swedish pharmacies with organizational objectives that necessitates a monitoring of efficiency and productivity as well as customer satisfaction. Estimation results from the network model and a direct productivity model (without customer satisfaction) are compared and indicate that the technical efficiency is lower under the network model. The productivity results indicate productivity progress under both models, albeit with a slower rate of change under the network model.
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| 9. |
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