Applied Health Economics for Public Health Practice and Research

2019 ◽  
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Health Economics ◽  
Case Studies ◽  
Population Health ◽  
Evidence Synthesis ◽  
Health Interventions ◽  
Public Healthcare ◽  
Economic Modelling ◽  
Public Health Interventions

Public health has been described as the organized activities of society to improve and protect the health of the population. Health economics applied to public health is the study of how we allocate our scarce societal resources to meet our public health wants and needs in the best way possible. This book presents current thinking on health economics methodology and application to the evaluation of public health interventions (PHIs). It is for health economists working in higher education and public healthcare systems, challenged with the economic evaluation of PHIs, when they have been used to applying health economics and the methods of economic evaluation to narrower clinical interventions in primary or secondary care settings. This book will also be of interest to public health practitioners wanting to incorporate health economics into their daily work. This book covers the history of economics of public health and the economic rationale for government investment in prevention; principles of health economics including scarcity, choice, and opportunity cost; evidence synthesis; key methods of economic evaluation with accompanying case studies; economic modelling of public health interventions; return on investment analysis with national and international case studies; and application of programme budgeting and marginal analysis (PBMA) to the prioritization of PHIs. It concludes with priorities for research in the field of public health economics, spanning an acknowledgement of the role played by the natural environment in promoting better health, through to precision public health, recognizing the role of genetics, the environment, and socioeconomic status in determining population health.

Synthesizing evidence for economic evaluations of public health interventions

2019 ◽  
pp. 87-106
Author(s):  
Olivia Wu ◽  
Joanna M. Charles ◽  
Nathan Bray
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Evidence Synthesis ◽  
Good Practice ◽  
Relevant Literature ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Narrative Synthesis ◽  
Public Health Interventions

Reviewing and synthesizing evidence is an important component of the toolkit of methods for the economic evaluation of PHIs. Chapter 4 provides readers with information about good practice in identifying relevant literature, judging the quality of relevant literature, and synthesizing evidence for economic evaluations of PHIs. Narrative synthesis has become a key focus in synthesizing complex PHIs. Readers are also introduced to the idea that logic (conceptual) models can be helpful in describing processes and hence outcomes. The chapter goes on to describe mixed-method reviews, realist synthesis, other forms of evidence synthesis, and equity considerations.

scholarly journals An analysis of COVID-19 clusters in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pooja Sengupta ◽  
Bhaswati Ganguli ◽  
Sugata SenRoy ◽  
Aditya Chatterjee
Keyword(s):  
Public Health ◽  
Cluster Analysis ◽  
Population Density ◽  
Case Studies ◽  
Compartment Model ◽  
Health Interventions ◽  
Disease Spread ◽  
Second Phase ◽  
Public Health Interventions ◽  
Homogeneous Groups

Abstract Background In this study we cluster the districts of India in terms of the spread of COVID-19 and related variables such as population density and the number of specialty hospitals. Simulation using a compartment model is used to provide insight into differences in response to public health interventions. Two case studies of interest from Nizamuddin and Dharavi provide contrasting pictures of the success in curbing spread. Methods A cluster analysis of the worst affected districts in India provides insight about the similarities between them. The effects of public health interventions in flattening the curve in their respective states is studied using the individual contact SEIQHRF model, a stochastic individual compartment model which simulates disease prevalence in the susceptible, infected, recovered and fatal compartments. Results The clustering of hotspot districts provide homogeneous groups that can be discriminated in terms of number of cases and related covariates. The cluster analysis reveal that the distribution of number of COVID-19 hospitals in the districts does not correlate with the distribution of confirmed COVID-19 cases. From the SEIQHRF model for Nizamuddin we observe in the second phase the number of infected individuals had seen a multitudinous increase in the states where Nizamuddin attendees returned, increasing the risk of the disease spread. However, the simulations reveal that implementing administrative interventions, flatten the curve. In Dharavi, through tracing, tracking, testing and treating, massive breakout of COVID-19 was brought under control. Conclusions The cluster analysis performed on the districts reveal homogeneous groups of districts that can be ranked based on the burden placed on the healthcare system in terms of number of confirmed cases, population density and number of hospitals dedicated to COVID-19 treatment. The study rounds up with two important case studies on Nizamuddin basti and Dharavi to illustrate the growth curve of COVID-19 in two very densely populated regions in India. In the case of Nizamuddin, the study showed that there was a manifold increase in the risk of infection. In contrast it is seen that there was a rapid decline in the number of cases in Dharavi within a span of about one month.

The use of modelling approaches for the economic evaluation of public health interventions

2019 ◽  
pp. 248-278
Author(s):  
Hazel Squires ◽  
Kathleen Boyd
Keyword(s):  
Public Health ◽  
Health Economic ◽  
Economic Evaluation ◽  
Health Economic Evaluation ◽  
Health Interventions ◽  
Primary Data ◽  
Public Health Interventions ◽  
Modelling Framework ◽  
Decision Analytic Modelling ◽  
Complex Relationships

This chapter considers the use of modelling for public health economic evaluation. The approach to decision analytic modelling within health economic evaluation is described and five key challenges relating to modelling public health interventions are highlighted: incorporating equity; extrapolating multi-component intervention effectiveness beyond study data; capturing relevant complex relationships and feedback loops of a dynamically complex system; modelling human behaviour; and capturing relevant non-health costs and outcomes and the relationship between individual and social determinants. The chapter describes current practice and the latest methodological research in these areas. It outlines two general approaches which could help to address these challenges by (i) adopting an iterative approach to the evaluation by using early-stage decision modelling to guide primary data collection, and (ii) a conceptual modelling framework to guide the model development process.

Applying methods of economic evaluation to public health: Contemporary solutions to traditional challenges

2019 ◽  
pp. 53-86
Author(s):  
Rhiannon T. Edwards ◽  
Emma McIntosh
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Study Design ◽  
Controlled Trial ◽  
Good Practice ◽  
Health Sector ◽  
Complex Interventions ◽  
Health Interventions ◽  
Natural Experiments ◽  
Public Health Interventions

Chapter 3 opens with a discussion of the role of study design, the gold standard traditionally being a randomized controlled trial, and widens this to consider other types of study design such as cohort studies and natural experiments. Readers are introduced to the idea that many public health interventions are ‘complex interventions’ and there is a need for a ‘systems-based approach’ to understanding their potential effectiveness and cost-effectiveness. The chapter highlights the relevance of behavioural economics to the evaluation of public health interventions. This chapter goes on to summarize a range of challenges faced by economists, used to evaluate healthcare technologies in a healthcare setting, when they start evaluating public health interventions, which are often delivered outside the health sector in, for example, schools and workplaces. UK guidance from NICE is presented on good practice in economic evaluation of public health interventions along with ideas about how such evaluations are best reported in the literature.

scholarly journals An overview of systematic reviews of economic evaluations of pharmacy-based public health interventions: addressing methodological challenges

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Suzete Costa ◽  
Maria Cary ◽  
Dennis K. Helling ◽  
João Pereira ◽  
Céu Mateus
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Systematic Reviews ◽  
Quality Criteria ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Synthesis Methods ◽  
Public Health Interventions ◽  
Overview Of Systematic Reviews ◽  
Pharmacy Interventions

Abstract Background Pharmacy interventions are a subset of public health interventions and its research is usually performed within the scope of a trial. The economic evaluation of pharmacy interventions requires certain considerations which have some similarities to those of public health interventions and to economic evaluations alongside trials. The objective of this research is to perform an overview of systematic reviews of economic evaluations of pharmacy services and triangulate results with recommendations for economic evaluations of both public health interventions and alongside trials. Methods (1) Exploratory review of recommendations on the economic evaluation of public health interventions, (2) exploratory review of recommendations for conducting economic evaluations alongside trials, (3) overview of systematic reviews of economic evaluations of pharmacy interventions (protocol registered with PROSPERO 2016 outlining information sources, inclusion criteria, appraisal of reviews and synthesis methods). Results Fourteen systematic reviews containing 75 index publications were included. Reviews reported favorable economic findings for 71% of studies with full economic evaluations. The types of economic analysis are diverse. Two critical quality domains are absent from most reviews. Key findings include the following: certain types of risk of bias, wider scope of study designs, and most economic quality criteria met but some issues unresolved or unclear. Triangulation revealed additional gaps. Limitations include choice of critical quality domains and potential biases in the overview process. Conclusions Economic evaluations of pharmacy-based public health interventions seem to follow most economic quality criteria, but there are still some issues in certain key areas to improve. These findings may assist in improving the design of pilot trials of economic evaluations in pharmacy, leading to robust evidence for payers. Based on the findings, we propose a methodological approach for the economic evaluation of pharmacy-based public health interventions. Systematic review registration PROSPERO CRD42016032768

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