Source Critique 7

Source 7

Introduction to Health Economics For the Medical Practitioner

Kernick, D. (2003). Introduction to Health Economics For the Medical Practitioner. British Medical Journal, 79-929.

Purpose

This article overviews the application and basic principles of health care economics. Secondary to the general principles of health economics, it examines economic evaluation.

Strengths and Weaknesses

      Strengths:

• Addresses issues related to increasing consumer awareness
• Assists in organizing and financing health care
• Assesses benefits and costs of different health care interventions

      Weaknesses:

• Does not effectively account for different professional perspectives
• Widely contested analytical tool within the health care community

Description

The article compared and contrasted different types of health care economic models. The focus of the paper is a general overview of health care economics and not a specific resource for the execution of any particular model. The article is a general baseline to assist in understanding the principles of why analysis is important and how it is used.

Uses

Cost Utility Analysis may be used to address both cost and possible benefits related to a health care intervention. It is beneficial to help compare different areas of treatment and their programs.

Comparison

This article provides a very basic ideology behind health care economics. It does not present any strong opinions either way about any specific principle. The publication appears unbiased and demonstrates a factual presentation of principle rather than a suggestion of how or what to use within the professional industry.

Most Informative

The most informative element of this article is the comparison of many different analytical methods used for heath care economics. It is beneficial to consolidate the different methods in one location to be able to determine in which scenarios to use each one.

Source Author

Dr. Kernick is a staff member at the St. Thomas Health Centre, United Kingdom. Also, he serves at the Peninsula College of Medicine and Dentistry. Dr. Kernick has several post-graduate degrees in the healthcare field such as: BSc, MD, FRCGP, DA, DCH, DRCOG. As the author of this article, Dr. Kernick has more than sufficient education and knowledge regarding the subject matter and is a reliable source for the healthcare economic related topics.

Source Reliability

According to the Dax Norman Trust Evaluation Worksheet for online sources, the source has a High Reliability rating.

Sources Cited

The author listed the following sources for this article:

·      Armstrong, R. A., Brickley, M. R., Shepherd, J. P. and Kay, E. J. (1995) Healthy decision-making: a new approach in health promotion using health state utilities, Community Dental Health, 12, 8–11.

·    Kernick D. Getting health economics into practice. Abingdon: Radcliffe Press, 2002.

·    Jefferson T. Elementary economic evaluation. London: BMJ Books, 2000.

·    Donaldson C. Evidence based health economics. London: BMJ Books, 2002.

·    The BMJ Health Economics Collection: www.bmj.com/cgi/collection/health_economics.

Critique Author

Mark L.

sapperlt@gmail.com

Mercyhurst College, Erie PA,

Advanced Analytic Techniques Course

February 5, 2011

Source 6 Critique

Source 6

An Introduction to Economic Evaluation of Health Care

Cunningham, S. (2001, September). An Introduction to Economic Evaluation of Health Care. Journal of Orthodontics, 28-3.

Cost Utility Analysis

Purpose

This article focuses on the application of health care economics and the overarching principles which must be considered when applying utility analysis to a subject.

Strengths and Weaknesses

       Strengths:

• Widely accepted tool for health appraisal
• Assists in health care efficiency
• Addresses societal concerns about the value of human life

           Weaknesses:

• Dependant of the quality of given medical evidence
• Its purpose and ethics are often misunderstood by clinicians
• Does not readily account for time differences in costs and outcomes

Description

The article did not explain or address the CUA method in specific detail. The focus of the paper is a macro look at healthcare utility and analysis methods used to contribute to it. A particular focus on orthodontics and dentistry is presented in this article.

Uses

Utility analysis methods, such as CUA, address outcome valuation. Their inherent utility is to determine whether a course of action is worthwhile. CUA requires appraisals of its specific applicability to a situation and answers to questions required to determine its suitability to a problem set.

Comparison

This article provides a unique perspective on CUA because of its application to dentistry and orthodontics. Since theses fields bare less life-threatening situations than more traditional medical practices, the idea of preventative costs demonstrates a different application for utility analysis methods in healthcare.

Most Informative

The most informative element of this article is the introduction and assessment of CUA and other utility analysis methods to dentistry. The article admits that the field has not seen enough use of these methods and should embrace more opportunities to utilize these tools.

Source Author

Susan Cunningham is a senior lecturer and professor at the Department of Orthodontics within the Eastman Dental Institute, United Kingdom. Ms. Cunningham has several post-graduate degrees in the healthcare field and is a program coordinator at the intitute. As the author of this article, Cunningham has adequate education and knowledge regarding the subject matter and is a reliable source regarding the healthcare topics.

Source Reliability

According to the Dax Norman Trust Evaluation Worksheet for online sources, the source has a High Reliability rating.

Sources Cited

The author listed the following sources for this article:

Armstrong, R. A., Brickley, M. R., Shepherd, J. P. and Kay, E. J. (1995) Healthy decision-making: a new approach in health promotion using health state utilities, Community Dental Health, 12, 8–11.

Brickley, M., Armstrong, R., Shepherd, J. and Kay, E. (1995) The relevance of health state utilities to lower third molar surgery, International Dental Journal, 45, 124–128.

Carr-Hill, R. A. (1991) Allocating resources to health care: is the QALY (Quality Adjusted Life Year) a technical solution to a political problem? International Journal of Health Services, 21, 351–363.

Cunningham, S. J. and Hunt, N. P. (2000a) A comparison of health state utilities for dentofacial deformity as derived from patients and the general public, European Journal of Orthodontics, 22, 335–342.

Cunningham, S. J. and Hunt, N. P. (2000b) The relationship between utility values and willingness-to-pay in orthognathic patients, Community Dental Health, 17, 92–96.

Donaldson, C. (1990) The state of the art of costing health care for economic evaluation, Community Health Studies, 14, 341–356.

Donaldson, C. (1998) Economic evaluation in dentistry: an ethical imperative? Dental Update, 25, 260–264.

Downer, M. C. and Moles, D. R. (1998) Health gain from restorative dental treatment evaluated by computer simulation, Community Dental Health, 15, 32–39.

Downer, M. C., Jullien, J. A. and Speight, P. M. (1997) An interim determination of health gain from oral cancer and pre-cancer screening: 1. Obtaining health state utilities, Community Dental Health, 14, 139–142.

Drummond, M. F. and Davies, L. (1991) Economic analysis alongside clinical trials. Revisiting the methodological issues, International Journal of Technology Assessment in Health Care, 7, 561–573.

Drummond, M. F., Stoddart, G. L. and Torrance, G. W. (1987) Methods for the Economic Evaluation of Health Care Programmes,Oxford University Press, Oxford.

Evans, R. G. and Robinson, G. C. (1980) Surgical day care: measurements of the economic payoff, Canadian Medical Association Journal, 123, 873–880.

Evans, R. and Shaw, W. (1987) Preliminary evaluation of an illustrated scale for rating dental attractiveness, European Journal of Orthodontics, 9, 314–318.

Forbes, R. B., Lees, A., Waugh, N. and Swingler, R. J. (1999) Population based cost utility study of interferon beta-1b in secondary progressive multiple sclerosis, British Medical Journal, 319, 1529–1533.

Fox, D., Kay, E. J. and O'Brien, K. D. (2000) A new method of measuring how much anterior tooth alignment means to adolescents, European Journal of Orthodontics, 22, 299–305.

Fyffe, H. E. and Kay, E. J. (1992) Assessment of dental health state utilities, Community Dentistry and Oral Epidemiology, 20, 269–273.

Gerard, K. and Mooney, G. (1993) QALY league tables: handle with care, Health Economics, 2, 59–64.

Hine, D. (1999) For the good that it will do: issues confronting healthcare in the UK, Journal of the Royal Society of Medicine, 92, 332–338.

Klock, B. (1980) Economic aspects of a caries preventive program, Community Dentistry and Oral Epidemiology, 8, 97–102.

Krischer, J. P. (1976) Utility structure of a medical decision-making problem, Operations Research, 24, 951–972.

Mjör, I. A. (1992) Long term cost of restorative therapy using different materials, Scandinavian Journal of Dental Research, 100, 60–65.

Mjör, I. A., Burke, F. J. T. and Wilson, N. H. F. (1997) The relative cost of different restorations in the UK, British Dental Journal, 182, 286–289.

Morgan, M. V., Crowley, S. J. and Wright, C. (1998) Economic evaluation of a pit and fissure dental sealant and fluoride mouthrinsing program in two nonfluoridated regions of Victoria, Australia, Journal of Public Health Dentistry, 58, 19–27.

NHS Centre for Reviews and Dissemination, University of York (1999) Dental restoration: what type of filling? Effective Health Care, 5, 1–12.

Petrou, S. and Renton, A. (1993) The QALY: A guide for the public health physicianPublic Health, 107, 327–336.

Robinson, R. (1993a) Economic analysis and health care. What does it mean? British Medical Journal, 307, 670–673.

Robinson, R. (1993b) Costs and cost-minimisation analysis, British Medical Journal, 307, 726–728.

Robinson, R. (1993c) Cost-effectiveness analysis, British Medical Journal, 307, 793–795.

Robinson, R. (1993d) Cost-utility analysis, British Medical Journal, 307, 859–862.

Robinson, R. (1993e) Cost-benefit analysis, British Medical Journal, 307, 924–926.

Sendi, P. P., Palmer, A. J. and Marinello, C. P. (1997) Health state utilities in dentistry: a review, Acta Medica Dentistry Helvetia, 2, 243–248.

Severens, J. L., Prahl, C., Kuijpers-Jagtman, A. M. and Prahl-Andersen, B. (1998) Short-term cost-effectiveness analysis of presurgical orthopedic treatment in children with complete unilateral cleft lip and palate, Cleft Palate and Craniofacial Journal, 35, 222–226.

Smales, R. J. and Hawthorne, W. S. (1996) Long-term survival and cost-effectiveness of five dental restorative materials used in various classes of cavity preparations, International Dental Journal, 46, 126–130.

Torgerson, D. J. and Raftery, J. (1999) Economics notes. Discounting, British Medical Journal, 319, 914–915.

Torrance, G. W. (1982)Preferences for health states: a review of measurement methods,In Clinical and Economic Evaluation of Perinatal Programmes (ed. J. C. Sinclair),Proceedings of the Mead Johnson Symposium on Perinatal and Developmental Medicine, 20, pp. 37–45.

Zarnke, K. B., Levine, M. A. H. and O'Brien, B. J. (1997) Cost-benefit analyses in the health-care literature: don't judge a study by its label, Journal of Clinical Epidemiology, 50, 813–822.  

Critique Author

Mark L.

sapperlt@gmail.com

Mercyhurst College, Erie PA,

Advanced Analytic Techniques Course

February 5, 2011

Source 5 Critique

Source 5

Summarising economic evaluations in systematic reviews: a new approach
Nixon, J., Khan, K., and Kleijnen, J. (2001, June 30). Summarising economic evaluations in systematic reviews: a new approach. British Medical Journal, 322.

Cost Utility Analysis

Purpose
This article explores different methods of analysis which include cost utility and provides insight on different ways to utilize and communicate the data.

Strengths and Weaknesses

       Strengths:

• Uses clinical and economic evidence.

• Articulates reviews and findings.

• Utilizes different methods to report data.

           Weaknesses:

• Is not clear and utilitarian in summarizing data.

• Requires re-tooling.

• Is not well established as a reporting method.

Description
The article did not explain or address the CUA method with any detail. The focus of the paper is on the post-analytical reporting methods. Although CUA and similar tools are used to determine quantitative figures, the authors state that there should be clearer and more decision-maker-friendly tables or results to articulate the findings.

Uses
Utility analysis methods, such as CUA, are ways of producing a value which can be used by decision-makers to best determine courses of action. Summarizes economic evaluations and presents options to clinicians and policy makers.

Comparison
This paper surpasses the basics of using CUA and moves on to discussing reporting methods once the data has been determined. Its function would be best geared towards personnel who are involved in presenting information to decision-makers, or those who may be required to interpret data that is presented to them.

Most Informative
The most informative element of this paper is the graphical demonstration of the different methods to present economically analyzed data. Additionally, the authors present theories and techniques which may benefit decision-makers, or others involved in the process, in deciphering the analysis presented to them.

Source Author
John Nixon is a professor at the University of York and also serves as a freelance health economist. Mr. Nixon has a history of serving as a developer and manager of health economic review projects such as the NHS Economic Evaluation Database and the European Network of Health Economic Evaluation Database. Mr. Nixon has over 15 years in post-graduate experience in the field of health economics. As the author of this article, Nixon and his co-authors Khalid Khan and Jos Kleijnen have extensive education and knowledge regarding the subject matter and are very reliable sources regarding the reporting methods of CUA and other economic evaluation tools.

Source Reliability
According to the Dax Norman Trust Evaluation Worksheet for online sources, the source has a High Reliability rating.

Sources Cited
The author of the commentary listed the following sources for further information:

• NHS Executive. Faster access to modern treatment: how NICE appraisal will work. In: London: NHS Executive, 1999.

• Nixon J, Stoykova B, Christie J, Glanville JM, Drummond MF, Kleijnen J. The UK NHS economic evaluation database: economic issues in evaluations of health technology. Int J Health Technol Assess 2000; 16: 1–12.

• Nixon J, Stoykova B, Christie J, Glanville JM, Kleijnen J, Drummond MF. NHS economic evaluation database for healthcare decision makers. BMJ 2000; 321: 32.

• NHS Centre for Reviews and Dissemination. Undertaking systematic reviews of research on effectiveness. CRD's guidance for carrying out or commissioning reviews. 2nd ed. York: NHS Centre for Reviews and Dissemination, 2000.

• Black WC. The CE plane: a graphic representation of cost-effectiveness. Med Decis Making 1990; 10: 212–214.

• Geisler E, Heller O, Birch S, Gaffni A. Cost-effectiveness and cost utility analyses: methods for the non-economic evaluation of healthcare programs and how we can do better. In: Geisler E, Heller O, ed. Managing technology in healthcare. Norwell, MA: Kluwer Academic, 1996.

• Drummond MF, O'Brien B, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. 2nd ed. Oxford: Oxford University Press, 1999.

• Lister-Sharp D, McDonough M, Khan K, Kleijnen J. A rapid and systematic review of the effectiveness and cost effectiveness of taxanes used in the treatment of advanced breast and ovarian cancer. Health Technol Assess 2000; 4: 1–113.

• Browne G, Roberts J, Gafni A, Byrne C, Weir R, Majumdar B, et al. Economic evaluations of community-based care: lessons from twelve studies in Ontario. J Eval Clin Pract 1999; 5: 367–385.

• Kwaliteitsinstituut voor de gezondheidszorg CBO [Dutch Institute of Healthcare Improvement]. Guideline cholesterol. Utrecht: Kwaliteitsinstituut voor de gezondheidszorg CBO, 1997.

Critique Author
Mark L.

sapperlt@gmail.com

Mercyhurst College, Erie PA,

Advanced Analytic Techniques Course

January 26, 2011