Comparing health care options using the cost-benefit utility ratio

To the Editor.— Two recent reviews in Pediatrics1,2 provide much interesting information on the effect of home visits on the health of women and children. However, I was disappointed not to find in either article more than token reference to the cost of the programs reviewed. In this day of increasingly scarce health care resources, we no longer have the luxury of evaluating programs such as these without detailed consideration of their cost-benefit ratio.

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An Economic Analysis and Approach for Health Care Preparedness in a Substate Region

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2015.37 ◽

2015 ◽

Vol 9 (4) ◽

pp. 344-348 ◽

Cited By ~ 2

Author(s):

Benoit Stryckman ◽

Thomas L. Grace ◽

Peter Schwarz ◽

David Marcozzi

Keyword(s):

Health Care ◽

Emergency Response ◽

Return On Investment ◽

Catchment Area ◽

Cost Benefit Analysis ◽

Cost Benefit ◽

Benefit Analysis ◽

Response Team ◽

The Cost ◽

Positive Return

AbstractObjectiveTo demonstrate the application of economics to health care preparedness by estimating the financial return on investment in a substate regional emergency response team and to develop a financial model aimed at sustaining community-level disaster readiness.MethodsEconomic evaluation methods were applied to the experience of a regional Pennsylvania response capability. A cost-benefit analysis was performed by using information on funding of the response team and 17 real-world events the team responded to between 2008 and 2013. By use of the results of the cost-benefit analysis as well as information on the response team’s catchment area, a risk-based insurance-like membership model was built.ResultsThe cost-benefit analysis showed a positive return after 6 years of investment in the regional emergency response team. Financial modeling allowed for the calculation of premiums for 2 types of providers within the emergency response team’s catchment area: hospitals and long-term care facilities.ConclusionThe analysis indicated that preparedness activities have a positive return on their investment in this substate region. By applying economic principles, communities can estimate their return on investment to make better business decisions in an effort to increase the sustainability of emergency preparedness programs at the regional level. (Disaster Med Public Health Preparedness. 2015;9:344–348)

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Cost/benefit of synbiotics in acute infectious gastroenteritis: spend to save

Beneficial Microbes ◽

10.3920/bm2012.0007 ◽

2012 ◽

Vol 3 (3) ◽

pp. 189-194 ◽

Cited By ~ 15

Author(s):

Y. Vandenplas ◽

S. De Hert

Keyword(s):

Health Care ◽

Placebo Group ◽

Concomitant Medication ◽

Health Care Cost ◽

Cost Benefit ◽

Food Supplement ◽

Food Supplementation ◽

Ambulatory Treatment ◽

Infectious Gastroenteritis ◽

The Cost

The cost/benefit ratio of probiotics in the ambulatory treatment of acute infectious gastro-enteritis with or without a synbiotic food supplement (containing fructo-oligosaccharides and probiotic strains of Streptoccoccus thermophilus, Lactobacillus rhamnosus, Lactobacillus acidophilus, Bifidobacterium lactis and Bifidobacterium infantis) has been studied. 111 children (median age 37 and 43 months for the synbiotic and placebo group, respectively) with acute infectious gastroenteritis were included in a randomised, prospective placebo-controlled trial performed in primary health care. All children were treated with an oral rehydration solution and with the synbiotic food supplement (n=57) or placebo (n=54). Physicians were allowed to prescribe additional medication according to what they considered as ‘necessary’. Cost of add-on medication and total healthcare cost were calculated. Median duration of diarrhoea was 1 day shorter (95% confidence interval -0.6 to -1.9 days) in the symbiotic than in the placebo group (P<0.005). Significantly more concomitant medication (antibiotics, antipyretics, antiemetics) was prescribed in the placebo group (39 prescriptions in 28 patients) compared to the synbiotic group (12 prescriptions in 7 patients) (P<0.001). The difference was most striking for antiemetics: 28 vs. 5 prescriptions. The cost of add-on medication in the placebo group was evaluated at € 4.04/patient (median 4.97 (interquartile (IQ) 25-75: 0-4.97)) vs. € 1.13 /patient in the synbiotic arm (P<0.001). If the cost of the synbiotic is considered, median cost raised to € 7.15/patient (IQ 25-75: 7.15-7.15) (P<0.001). The extra consultations needed to prescribe the concomitant medication resulted in a higher health care cost in the placebo group (€ 14.41 vs. € 10.74/patient, P<0.001). Synbiotic food supplementation resulted in a 24 h earlier normalisation of stool consistency. Although use of the synbiotic supplementation increased cost, add-on medication and extra consultations were reduced, resulting in a reduction of health care cost of 25%.

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Biofutures: Race and the governance of health

Environment and Planning D Society and Space ◽

10.1177/0263775816654475 ◽

2016 ◽

Vol 35 (2) ◽

pp. 222-240 ◽

Cited By ~ 4

Author(s):

Shiloh Krupar ◽

Nadine Ehlers

Keyword(s):

Health Care ◽

Information System ◽

Geographic Information System ◽

Health Care System ◽

Cost Benefit ◽

Structural Racism ◽

Gis Technologies ◽

Spatial Profiling ◽

The Cost ◽

The U.S

This article addresses biomedical forms of racial targeting under neoliberal biopolitics. We explore two racial targeting technologies: The development of race-based pharmaceuticals, specifically BiDil; and medical hot spotting, a practice that uses Geographic Information System (GIS) technologies and spatial profiling to identify populations that are medically vulnerable in order to facilitate preemptive care. These technologies are ostensibly deployed under neoliberal biopolitics and the governance of health to affirm life. We argue, however, that these efforts further subject racial minorities—and specifically black subjects—to the cost–benefit logics of neoliberalism in the U.S. health care system and enduring anti-blackness. What is called for is an abolitionist biomedicine that recognizes and seeks to challenge the multifarious ways that race is ontologized as a corporeal and/or spatial truth while attending to the very real embodied effects of structural racism.

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Economic evaluation of passive monitoring technology for seniors

Aging Clinical and Experimental Research ◽

10.1007/s40520-019-01323-2 ◽

2019 ◽

Vol 32 (7) ◽

pp. 1375-1382

Author(s):

John E. Schneider ◽

Jacie Cooper ◽

Cara Scheibling ◽

Anjani Parikh

Keyword(s):

Health Care ◽

Conceptual Model ◽

Independent Living ◽

Care Pathway ◽

Cost Savings ◽

Cost Benefit ◽

Standard Of Care ◽

Passive Monitoring ◽

Monitoring Technology ◽

The Cost

Abstract Background Advances such as passive monitoring technology (PMT), which provides holistic supervision of chronically ill and elderly patients, enable and support improved monitoring and observation, thus empowering the growing population of older adults to live more independently while lowering health care expenses. Aims This study develops a conceptual model to estimate the potential savings associated with PMT. Methods We first develop a conceptual model to identify the main cost variables associated with independent living, focusing on three pathways: (1) PMT, (2) independent living supported by the current standard of care, and (3) facility-based care. We examined the impact on three outcomes [i.e., health care costs, institutional costs, and health-related quality of life (HRQoL)] along each of the three care pathways (i.e., PMT, independent living supported by the standard of care, and facility-based care) and developed a cost-benefit model to calculate the net costs and benefits associated with each care pathway. Results The cost–benefit model showed savings between approximately $425 per-member per-month (PMPM) for those using PMT compared to those on the standard of care pathway. Sensitivity analysis demonstrated that a 5% increase in nursing home utilization generates cost savings of more than 30% PMPM. Discussion The total projected cost savings for individuals on the PMT arm are projected to be more than $425 PMPM, with annual savings of $5069 per-person per-year, and over $5.1 million for a target population of 1000 individuals. Conclusions The cost calculations in our cost–benefit simulation model clearly demonstrate the value of PMT and show the potential value to payers and integrated delivery systems in offering PMT to individuals who are likely to benefit the most from the services.

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Nach welchen ökonomischen Methoden sollten Gesundheitsleistungen in Deutschland evaluiert werden? / According to Which Economic Methods Should Health Care Services Become Evaluated in Germany?

Jahrbücher für Nationalökonomie und Statistik ◽

10.1515/jbnst-2007-5-621 ◽

2007 ◽

Vol 227 (5-6) ◽

Author(s):

J.-Matthias Graf von der Schulenburg ◽

Christoph Vauth

Keyword(s):

Health Care ◽

Health Economic ◽

Health Care Services ◽

Health Economic Evaluation ◽

Cost Benefit ◽

Secondary Data ◽

Benefit Assessment ◽

Assessment Process ◽

Potential Conflict ◽

The Cost

SummaryThe paper presents the methodological challenges of the introduction of cost-benefit assessment by the German legislative (Competition Enhancement Act). Based on the standards for health economic evaluation accepted by the international scientific health economic community, this paper provides a minimum catalogue of methods and criteria to meet the legal German requirements. The methodological framework presented in this paper discusses the perspective to be used to evaluate cost and benefits, lists the appropriate study form, names the usage of primary or secondary data, the description of the cost and benefit calculation, shows the specific need on modelling and how to handle uncertainties and calls for a disclosure of potential conflict of interests.Further more, the paper contains detailed recommendations for the assessment-process in Germany. According to the new Competition Enhancement Act, the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) has to evaluate the cost-benefit ratio of pharmaceuticals in Germany. The process should be organised within two sequently parts: At first the development of a reporting plan that defines the comparative interventions to be included, the target criteria, assessment methods and the schedule to be observed, and secondly the implementation of the cost-benefit assessment.

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The Economic Consequences of not Treating Depression

The British Journal of Psychiatry ◽

10.1192/s0007125000293379 ◽

1995 ◽

Vol 166 (S27) ◽

pp. 29-33 ◽

Cited By ~ 24

Author(s):

Agnes Rupp

Keyword(s):

Health Care ◽

Mental Illness ◽

Conceptual Framework ◽

Affective Disorders ◽

Cost Benefit ◽

Economic Consequences ◽

Financial Resources ◽

Access To Treatment ◽

Benefit Evaluation ◽

The Cost

Background. A conceptual framework Is described for a broad cost–benefit evaluation of improved financial access to treatment of untreated affective disorders.Method. The analysis provides an estimate of the value of resources needed to provide improved access to treatment, and it compares these resources to the value of resources the improved access to treatment might save.Results. The cost–benefit analyses based on recent cost of mental illness studies provide some evidence that appropriately treating people with untreated affective disorders is cost-beneficial.Conclusion. Patients, providers and buyers of health care should be further encouraged to pay more attention and to commit more financial resources to the treatment of affective disorders.

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