Monitoring of Quality
A.F. Al-Assaf in Managed Care Quality, 2020
The indicator should be designed in such a way that it is nonobtrusive to the day-to-day operations of the health care organization. Ideally, the indicator is data driven from sources readily available to the organization. In addition, the data used for quality measurement and management should be the same data routinely used for patient care activities to avoid the development of parallel data sets. If the data required to profile the indicator requires medical record review, then the information needs to be readily identifiable in the medical record and definitions of the data item need to be clear enough to allow objective collection. The indicator should also be cost-effective. Cost-effectiveness is defined as the usefulness of the measure in relation to the cost of its application.
Implications for Risk Management
Samuel C. Morris in Cancer Risk Assessment, 2020
The benefit/cost ratio is only one way to express the results of a quantitative, analytical approach. Cost-effectiveness is a different way of using the same data. Cost-effectiveness is the quotient of the annualized cost of a risk management option divided by a measure of its effectiveness, e.g., dollars per cancer averted. One advantage of this approach is that there is no need to even consider reducing the effects (e.g., cancers) to monetary terms to match the costs. Also unlike benefit/cost analysis, there is usually no attempt made to include all the benefits. Cost-effectiveness generally refers to effectiveness in terms of a particular benefit. It is a single-focus measure. One must, thus, keep in mind that an option that is not cost effective in terms of cancer risk may have a high overall benefit/cost ratio due to other benefits. One study comparing individual risk levels, cost-effectiveness of the proposed action, and after-the-fact information on whether the regulatory agency did impose regulations, found that substances with lifetime cancer risks above 4×10−3 were regulated regardless of cost; for cancer risks below that level, regulation was imposed if the cost-per-cancer-averted was less than about $2 million (Travis et al., 1987). This is simply an observation from a limited data set, however. It implies no absolute rules for risk management decisions. Others cite much higher costs-per-cancer-averted for some actions. It is a useful measure for a decisionmaker to see. A high cost should make one wonder if the money might not be better spent elsewhere.
Cost-effective face-to-face learning
Kieran Walsh, Liam Donaldson in Cost Effectiveness in Medical Education, 2021
The concept of cost effectiveness—whereby something is deemed ‘effective or productive according to cost’1—depends crucially on being able to define a discrete effect or outcome that can then be costed. This immediately presents a problem in the context of face-to-face learning in medicine, which, especially in the clinical environment, is complex. Outcomes can be short term or may be ‘wide, long and deep’2 and are usually attained across several domains, including cognitive, psycho-motor, emotional or behavioural.3 Today’s basic science undergraduate lecture may seem irrelevant; however, later in the course of a student’s medical education, when this prior knowledge is activated and retrieved at the bedside of a real patient and their problem(s), it will make sense. This, along with an historical paucity of valid and reliable tools for assessing educational effectiveness, may be one of the reasons that cost-effectiveness analysis has generally been overlooked in evaluation of medical education.4 Similarly, costing education is problematic, either at the level of a single teaching session or a whole programme.
Interventions to improve medication adherence in mental health: the update of a systematic review of cost-effectiveness
Published in International Journal of Psychiatry in Clinical Practice, 2020
Lidia García-Pérez, Renata Linertová, Pedro Serrano-Pérez, Mar Trujillo-Martín, Leticia Rodríguez-Rodríguez, Cristina Valcárcel-Nazco, Tasmania del Pino-Sedeño
A cost-effectiveness analysis (also called economic evaluation) is a ‘comparative analysis of alternative courses of action in terms of both their costs and consequences’ (Drummond et al. 2005). This type of study is useful to know whether an intervention provides value for money and, consequently, is needed to inform the policymakers’ decisions. A systematic review of cost-effectiveness studies of interventions aimed at improving medication adherence of people with mental health problems found that this type of study was scarce at the time (2011) (García-Pérez and Serrano-Aguilar 2011). Only four completed studies were identified (Healey et al. 1998; Katon et al. 2002; von Knorring et al. 2006; Bosmans et al. 2007) and their heterogeneity and methodological quality prevented robust conclusions. The aim of the present article was to revisit this topic by updating the aforementioned review where the scope was the cost-effectiveness of interventions to enhance medication adherence in patients with mental health problems.
Estimating the clinical effectiveness and value-based price range of erenumab for the prevention of migraine in patients with prior treatment failures: a US societal perspective
Published in Journal of Medical Economics, 2018
Richard B. Lipton, Alan Brennan, Stephen Palmer, Anthony J. Hatswell, Joshua K. Porter, Sandhya Sapra, Guillermo Villa, Neel Shah, Stewart Tepper, David Dodick
The VBP ranges presented in this study represent the value of erenumab, as assessed within the scenarios described under a cost-effectiveness framework. However, cost-effectiveness is just one criterion against which value can be assessed, and affordability and other factors also impact final price. In this study, erenumab showed consistent and meaningful improvements in migraine day frequency and QALY compared to SC for patients who have failed at least one prior generic preventive therapy. The results presented provide the range of prices at which erenumab would be considered a valuable addition as migraine prevention in people with migraine, based on established WTP thresholds in the US. The value demonstration framework based on willingness to pay for health gains offers a meaningful approach to understand product value in relation to potential prices. Our analysis also highlights potential cost savings that can be achieved for people with migraine attributed to acute migraine day treatment costs, physician costs, and improved productivity output, suggesting benefits for both health services and broader societal impact. In the post-launch period, the economic results described here can be enriched to more accurately define clinical and economic value.
A study on the factors that influence the agility of COVID-19 hospitals
Published in International Journal of Healthcare Management, 2021
M. Suresh, A. Roobaswathiny, S. Lakshmi Priyadarsini
Cost effectiveness influences the type of RRT being built which includes forming an expert crew who can provide critical care. When a higher efficiency RRT is aimed, the cost that involved behind increases respectively, yet in most of the hospitals, the primary RRT is formed with the existing employees. Cost effectiveness is one of the major factors that influence the leader to take informed decisions with respect to the cost. For example, the purchase of new ventilators, new personnel protective equipment kits and new rapid testing kits are some of the common materials that the hospitals focus during this covid’19 pandemic. Cost influences the readiness for change factor positively, i.e. the more the physical or technological modifications the hospitals undergo, the more the cost would be. For example, huge wards with minimum patients with slight modifications are being converted into Covid units. When it comes to the point of meeting the increased number of patients (demand), the more flexible the hospitals are, the higher the cost would be for expanding the capacity. Cost effectiveness has an influence in the way of teaching newer technology to the RRT. It also influences the biomedical waste management by reducing the number of waste, with more recycling and reuse options.
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