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Departures from Cost-Effectiveness Recommendations: The Impact of Health System Constraints on Priority Setting
| Content Provider | Scilit |
|---|---|
| Author | Hauck, Katharina Thomas, Ranjeeta Smith, Peter C. |
| Copyright Year | 2016 |
| Description | Journal: Health Systems & Reform —The methods and application of cost-effectiveness analysis have reached an advanced stage of development. Many decision makers consider cost-effectiveness analysis (CEA) to be a valid and feasible approach toward setting health priorities, and it has been extensively applied in evaluating interventions and developing evidence-based clinical guidelines. However, the recommendations arising from cost-effectiveness analysis are often not implemented as intended. A fundamental reason for the failure to implement is that CEA assumes a single constraint, in the form of the budget constraint, whereas in reality decision makers may be faced with numerous other constraints. The objective of this article is to develop a typology of constraints that may act as barriers to implementation of cost-effectiveness recommendations. Six categories of constraints are considered: the design of the health system; costs of implementing change; system interactions between interventions; uncertainty in estimates of costs and benefits; weak governance; and political constraints. Where possible—and if applicable—for each class of constraint, the article discusses ways in which these constraints can be taken into account by a decision maker wishing to pursue the principles of cost-effectiveness. |
| Related Links | https://core.ac.uk/download/pdf/77008360.pdf |
| Ending Page | 70 |
| Page Count | 10 |
| Starting Page | 61 |
| ISSN | 23288604 |
| e-ISSN | 23288620 |
| DOI | 10.1080/23288604.2015.1124170 |
| Journal | Health Systems & Reform |
| Issue Number | 1 |
| Volume Number | 2 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2016-01-02 |
| Access Restriction | Open |
| Subject Keyword | Journal: Health Systems & Reform Health Policy and Services Cost-effectiveness Analysis Decision Making Health Technology Assessment Implementation Priority Setting |
| Content Type | Text |
| Subject | Health Information Management Public Health, Environmental and Occupational Health Health Informatics |
