Cost value analysis in health care: making sense out of QALYs
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Cambridge u.a.
Cambridge Univ. Press
1999
|
| Ausgabe: | 1. publ. |
| Schriftenreihe: | Cambridge studies in philosophy and public policy
|
| Schlagworte: | |
| Online-Zugang: | Sample text Publisher description Table of contents Inhaltsverzeichnis |
| Beschreibung: | XXIII, 157 S. |
| ISBN: | 0521644348 0521643082 |
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| 100 | 1 | |a Nord, Erik |e Verfasser |4 aut | |
| 245 | 1 | 0 | |a Cost value analysis in health care |b making sense out of QALYs |c Erik Nord |
| 246 | 1 | 3 | |a Cost-value analysis in health care |
| 250 | |a 1. publ. | ||
| 264 | 1 | |a Cambridge u.a. |b Cambridge Univ. Press |c 1999 | |
| 300 | |a XXIII, 157 S. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
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| 490 | 0 | |a Cambridge studies in philosophy and public policy | |
| 650 | 4 | |a Espérance de vie | |
| 650 | 7 | |a Gezondheidszorg |2 gtt | |
| 650 | 7 | |a Kosten-effectiviteitsanalyse |2 gtt | |
| 650 | 7 | |a Kwaliteit van het bestaan |2 gtt | |
| 650 | 4 | |a Medical care - Cost shifting | |
| 650 | 4 | |a Qualité de la vie | |
| 650 | 4 | |a Soins médicaux - Coût-efficacité - Modèles mathématiques | |
| 650 | 4 | |a Soins médicaux - Rationnement | |
| 650 | 4 | |a Gesundheitswesen | |
| 650 | 4 | |a Mathematisches Modell | |
| 650 | 4 | |a Health care rationing | |
| 650 | 4 | |a Medical care -- Cost effectiveness -- Mathematical models | |
| 650 | 4 | |a Quality of life | |
| 650 | 4 | |a Life expectancy | |
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Datensatz im Suchindex
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Contents
List of Tables and Figures page xiii
Preface and Acknowledgments xv
Overview xix
Reader's Guide xxiii
1 Maximizing Value in Health Care 1
1.1 Introduction 1
1.2 The rationale for numerical measures of value 2
1.3 Available numerical measures of value 4
2 Three Basic Issues in Economic Evaluation 7
2.1 At which levels of decision may economic
evaluation be helpful? 7
2.2 Values when caring for others versus values when
thinking about self interest 8
2.3 Resource allocation across programs is essentially
about making person trade offs 13
Appendix: Welfare economics and person trade offs 15
3 QALYs 18
3.1 What are QALYs? 18
3.2 Two major problems with QALYs 21
4 Concerns for Fairness 23
4.1 What is fairness? 23
4.2 QALYs and fairness 23
ix
Contents
4.3 Fairness and gains in utility 26
4.3.1 Severity of pretreatment condition 27
4.3.2 Realization of potential for health 28
4.3.3 Aversion to inequalities in health 29
4.4 Ways of measuring concerns for fairness 30
4.5 Societal concerns for severity 32
4.6 Rules of thumb concerning severity 37
4.7 Societal concerns for realizing potentials for health 38
4.8 Rules of thumb concerning severity and potentials
for health 42
4.9 The self interest perspective behind a veil of
ignorance 43
4.10 The degree of error in utility based predictions of
societal preferences 47
4.11 The importance of the duration of a treatment
effect 5°
4.12 Does discounting for time preference solve the
duration problem? 55
4.13 The importance of age 57
4.14 The importance of cost/the number of people
helped 61
4.15 The importance of the chance of successful
treatment 7°
4.16 Summary 73
4.17 Are better weights or additional equity weights a
solution? 74
5 The Limitations of Utility Measurement 79
5.1 Ex ante or ex post utilities? 8°
5.2 Whom to ask 82
5.2.1 The prima facie case for asking patients 82
5.2.2 Data on patients' quality of life 84
5.2.3 Hypothetical valuations: Arguments and
counterarguments "
5.2.4 The conventional use of hypothetical
valuations may be due to a conflation of issues 89
x
Contents
5.3 How to ask 90
5.3.1 The level of measurement 91
5.3.2 Understandability and verifiability 94
5.3.3 The quantity of wellness interpretation of
utility 96
5.3.4 The value interpretation of utility 100
5.3.5 Does the standard gamble capture all
aversion to risk? 102
5.3.6 Evidence based, understandable, and
verifiable utilities 105
5.3.7 The utility of minor and moderate
improvements 106
5.3.8 The ex ante value of life saving procedures 109
5.3.9 Summary and conclusion 111
6 Ways to Go 113
6.1 The problems 113
6.2 The person trade off issue revisited 115
6.3 Acknowledging the value of disabled people's lives 118
6.4 Disability Adjusted Life Years (DALYs) 121
6.5 Toward cost value analysis 123
6.6 Constructing a comprehensive value table 127
6.7 Measurement problems 128
6.8 The relevance of cost value analysis in practical
decision making 132
6.8.1 The usefulness of numbers 132
6.8.2 Decision levels 133
6.8.3 Winners take all? 139
6.9 Conclusion 141
Annex: An Example of Cost Value Analysis 143
References 146
Index 155
xi
Tables and Figures
TABLES
1 Responses to the question "How much more ill are you in
state X than in state 'no disability, mild distress'?" 34
2 Implied and directly measured person trade offs 36
3 Preferences for admission rules behind a veil of ignorance 44
4 Multi attribute utility instruments 48
5 Health state scores according to Rules of Thumb and
different multi attribute utility instruments 50
6 Life extending interventions (including self interest) 53
7 Health improving interventions (including self interest) 53
8 Ratios derived from Tables 6 and 7 53
9 Life extending interventions (for other people) 60
10 Health improving interventions (for other people) 61
11 Choices between three allocation rules 66
12 Preferences for the distribution of resources
across high cost and low cost patients 68
13 A scale of severity of illness 119
14 Values for different levels of severity of illness 119
15 Severity weights in Global Burden of Disease Study 122
16 Percentage of utilitarian preferences in five different choice
contexts 130
17 Cost value analysis of four programs 144
FIGURES
1 Self interest and ethical concerns in different decision
contexts 12
xiii
Tables and Figures
2 Differences in severity and treatment effect 26
3 Differences in values between health professionals and health
economists 135
4 Illustration of distribution of treatment capacity when
cost value considerations are disregarded 136
5 Distribution of treatment capacity when cost value
considerations are taken into account 138
xiv |
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| discipline | Soziologie Philosophie Wirtschaftswissenschaften |
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| isbn | 0521644348 0521643082 |
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| physical | XXIII, 157 S. |
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| spelling | Nord, Erik Verfasser aut Cost value analysis in health care making sense out of QALYs Erik Nord Cost-value analysis in health care 1. publ. Cambridge u.a. Cambridge Univ. Press 1999 XXIII, 157 S. txt rdacontent n rdamedia nc rdacarrier Cambridge studies in philosophy and public policy Espérance de vie Gezondheidszorg gtt Kosten-effectiviteitsanalyse gtt Kwaliteit van het bestaan gtt Medical care - Cost shifting Qualité de la vie Soins médicaux - Coût-efficacité - Modèles mathématiques Soins médicaux - Rationnement Gesundheitswesen Mathematisches Modell Health care rationing Medical care -- Cost effectiveness -- Mathematical models Quality of life Life expectancy Gesundheitswesen (DE-588)4020775-4 gnd rswk-swf Kosten-Nutzen-Analyse (DE-588)4032589-1 gnd rswk-swf Gesundheitswesen (DE-588)4020775-4 s Kosten-Nutzen-Analyse (DE-588)4032589-1 s DE-604 http://www.loc.gov/catdir/samples/cam032/99011394.html Sample text http://www.loc.gov/catdir/description/cam029/99011394.html Publisher description http://www.loc.gov/catdir/toc/cam025/99011394.html Table of contents HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008761516&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Nord, Erik Cost value analysis in health care making sense out of QALYs Espérance de vie Gezondheidszorg gtt Kosten-effectiviteitsanalyse gtt Kwaliteit van het bestaan gtt Medical care - Cost shifting Qualité de la vie Soins médicaux - Coût-efficacité - Modèles mathématiques Soins médicaux - Rationnement Gesundheitswesen Mathematisches Modell Health care rationing Medical care -- Cost effectiveness -- Mathematical models Quality of life Life expectancy Gesundheitswesen (DE-588)4020775-4 gnd Kosten-Nutzen-Analyse (DE-588)4032589-1 gnd |
| subject_GND | (DE-588)4020775-4 (DE-588)4032589-1 |
| title | Cost value analysis in health care making sense out of QALYs |
| title_alt | Cost-value analysis in health care |
| title_auth | Cost value analysis in health care making sense out of QALYs |
| title_exact_search | Cost value analysis in health care making sense out of QALYs |
| title_full | Cost value analysis in health care making sense out of QALYs Erik Nord |
| title_fullStr | Cost value analysis in health care making sense out of QALYs Erik Nord |
| title_full_unstemmed | Cost value analysis in health care making sense out of QALYs Erik Nord |
| title_short | Cost value analysis in health care |
| title_sort | cost value analysis in health care making sense out of qalys |
| title_sub | making sense out of QALYs |
| topic | Espérance de vie Gezondheidszorg gtt Kosten-effectiviteitsanalyse gtt Kwaliteit van het bestaan gtt Medical care - Cost shifting Qualité de la vie Soins médicaux - Coût-efficacité - Modèles mathématiques Soins médicaux - Rationnement Gesundheitswesen Mathematisches Modell Health care rationing Medical care -- Cost effectiveness -- Mathematical models Quality of life Life expectancy Gesundheitswesen (DE-588)4020775-4 gnd Kosten-Nutzen-Analyse (DE-588)4032589-1 gnd |
| topic_facet | Espérance de vie Gezondheidszorg Kosten-effectiviteitsanalyse Kwaliteit van het bestaan Medical care - Cost shifting Qualité de la vie Soins médicaux - Coût-efficacité - Modèles mathématiques Soins médicaux - Rationnement Gesundheitswesen Mathematisches Modell Health care rationing Medical care -- Cost effectiveness -- Mathematical models Quality of life Life expectancy Kosten-Nutzen-Analyse |
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