Source 2
Is economic evaluation in touch with society’s health values?
Coast, J. (2004, September 16). Is economic evaluation in touch with society’s health values? British Medical Journal, 329.
Coast, J. (2004, September 16). Is economic evaluation in touch with society’s health values? British Medical Journal, 329.
Cost Utility Analysis
Purpose
This commentary in the medical journal critiques the use of QUALYs (Quality Adjusted Life Year) as a measurement tool which is not fully understood by the decision makers that utilize it. The article explores opinions about different health-care measurement methods and the difficulties that each presents.
Strengths and Weaknesses
Strengths:
Purpose
This commentary in the medical journal critiques the use of QUALYs (Quality Adjusted Life Year) as a measurement tool which is not fully understood by the decision makers that utilize it. The article explores opinions about different health-care measurement methods and the difficulties that each presents.
Strengths and Weaknesses
Strengths:
o Attempts to maximize health output using
the available resources.
o Focuses efforts on achieving societal
health-care and wellness goals.
o Benefits the decision maker
Weaknesses:
o Validity of over-simplifying a complex issue.
o Meaningfulness to the decision maker
o Does not represent all of the decision
maker’s objectives
Description
The article did not specifically explain the process of using cost utility analysis, but did summarize the method. Simplifying a complex set of variables into a single unit of measurement known as QUALYs. The method funnels many health outcomes and results of intervention into one, simplistic measurement.
Uses
Used by decision makers in the health-care profession. It provides a simplistic unit of measurement to decision makers for use in maximizing societal health. The problems inherent to the use of CUA include the method’s inability to account for peripheral results of medical intervention. Examples of such unaccounted for information is the effect on non medical caretakers, family members, self esteem, and cognitive abilities. Also, this article questions the true ability for most decision makers to understand how QUALYs are arrived at, thus making their use a paradox. If the decision maker does not know how to use the tool in question, how are they going to effectively make the proper choices to satisfy their objectives?
Comparison
The article was similar to most articles related to the topic of CUA. It addressed specific pros and cons of the method but did not go into specific detail about how to use the tool or the formula used. This article appeared unbiased and was informative.
Sources Cited
The author of the commentary listed the following sources:
The author of the commentary listed the following sources:
Drummond M, McGuire A Briggs AH. Handling uncertainty in economic evaluation and presenting the results. In: Drummond M, McGuire A, eds. Economic evaluation in health care. Merging theory with practice Oxford: Oxford University Press, 2001: 172–214.
Drummond M, McGuire A Tsuchiya A, Williams A. Welfare economics and economic evaluation. In: Drummond M, McGuire A, eds. Economic evaluation in health care. Merging theory with practice Oxford: Oxford University Press, 2004: 22–45.
Sugden R, Williams A. The principles of practical cost-benefit analysis Oxford: Oxford University Press, 1978.
Brouwer WBF, Koopmanschap MA. On the economics foundations of CEA. Ladies and gentlemen, take your positions! J Health Econ 2000;19: 439–59.
Baldwin S, Culyer AJ. Commodities, characteristics of commodities, characteristics of people, utilities, and the quality of life. In: Baldwin S, ed. Quality of life. Perspectives and policies London: Routledge, 1989: 9–27.
Nussbaum MC, Sen A. Capability and well-being. In: Nussbaum MC, ed. The quality of life. Oxford: Clarendon Press, 1993.
Birch S, Donaldson C. Valuing the benefits and costs of health care programmes: where's the ‘extra’ in extra-welfarism? Soc Sci Med 2003;56: 1121–1133.
Loomes G, McKenzie L. The use of QALYs in health care decision making. Soc Sci Med 1989;28: 299–308.
Nord E, Richardson J, Street A, Kuhse H, Singer P. Maximising health benefits vs egalitarianism: an Australian survey of health issues. Soc Sci Med 1995;41: 1429–37.
Dolan P, Cookson R. A qualitative study of the extent to which health gain matters when choosing between groups of patients. Health Policy 2000;51: 19–30.
Klevit HD, Bates AC, Castanares T, Kirk EP, Sipes-Metzler PR, Wopat R. Prioritization of health care services. A progress report by the Oregon Health Services Commission. Arch Intern Med 1991;151: 912–6.
Allen D, Lee RH, Lowson K. The use of QALYs in health service planning. Int J Health Plann Manage 1989;4: 261–73.
Eddy DM. Oregon's methods. Did cost-effectiveness analysis fail? JAMA 1991;266: 2135–41.
New B. A good-enough service. Values, trade-offs and the NHS London: Institute for Public Policy Research, 1999.
Richards S, Coast J. Interventions to improve access to health and social care after discharge from hospital: a systematic review. J Health Serv Res Pol 2003;8: 171–9.
Drummond M, Brown R, Fendrick AM, Fullerton P, Neumann P, Taylor R. Use of pharmacoeconomics information-report of the ISPOR task force on use of pharmacoeconomic/health economic information in health-care decision making. Value Health 2003;6: 407–16.
Hoffman C, der Schulenburg JMG, EUROMET Group. The influence of economic evaluation studies on decision making. A European survey. Health Policy 2000;52: 179–92.
Cost-effectiveness thresholds. Economic and ethical issues. London: King's Fund, Office of Health Economics, 2002.
Jacklin PB, Roberts JA, Wallace P, Haines A, Harrison R, Barber JA, et al. Virtual outreach: economic evaluation of joint teleconsultations for patients referred by their general practitioner for a specialist opinion. BMJ 2003;327: 84.
Most Informative
The most informative insight from the article is the peripheral variables which are not addressed by the Cost Utility Analysis method. The most important consideration that must be addressed is decision makers’ ability to understand what QUALYs really are and how that unit of measurement is arrived at so that their decisions are informed to the greatest extent possible.
Source Author
Joanna Coast is a professor of health economics at the University of Birmingham in the United Kingdom, and has over 20 years in the field of health economics. Ms. Coast has conducted numerous works of research in the field of health care decision making and the use of qualitative methods in health economics. As the author of this article, Dr. McGregor has adequate education and knowledge regarding the subject matter and is a reliable source regarding the use of CUA.
Source Reliability
According to the Dax Norman Trust Evaluation Worksheet for online sources, the source has a High Reliability rating.
Critique Author
Mark L.
The most informative insight from the article is the peripheral variables which are not addressed by the Cost Utility Analysis method. The most important consideration that must be addressed is decision makers’ ability to understand what QUALYs really are and how that unit of measurement is arrived at so that their decisions are informed to the greatest extent possible.
Source Author
Joanna Coast is a professor of health economics at the University of Birmingham in the United Kingdom, and has over 20 years in the field of health economics. Ms. Coast has conducted numerous works of research in the field of health care decision making and the use of qualitative methods in health economics. As the author of this article, Dr. McGregor has adequate education and knowledge regarding the subject matter and is a reliable source regarding the use of CUA.
Source Reliability
According to the Dax Norman Trust Evaluation Worksheet for online sources, the source has a High Reliability rating.
Critique Author
Mark L.
Mercyhurst College, Erie PA,
Advanced Analytic Techniques Course
January 5, 2011
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