1 February 2018

Economic analysis of service and delivery interventions in health care

Economic analysis of service and delivery interventions in health care
Health Serv Deliv Res 2018;6(5)
  • Evaluating service innovations in health care and public health requires flexibility, collaboration and pragmatism; this collection identifies robust, innovative and mixed methods to inform such evaluations.
  • "Broadly speaking, there are two approaches to producing summative assessments of the costs and benefits of entire programmes. The first involves direct estimation of the summative impacts through exploitation of some experiment or other source of variation in implementation. The second involves modelling the causal chain through component processes to derive an aggregate measure where direct estimation is not feasible." see Recent developments
There are well-developed guidelines for economic evaluation of clearly defined clinical interventions, but no such guidelines for economic analysis of service interventions. Distinctive challenges for analysis of service interventions include diffuse effects, wider system impacts, and variability in implementation, costs and effects. Cost-effectiveness evidence is as important for service interventions as for clinical interventions. There is also an important role for wider forms of economic analysis to increase our general understanding of context, processes and behaviours in the care system. Methods exist to estimate the cost-effectiveness of service interventions before and after introduction, to measure patient and professional preferences, to reflect the value of resources used by service interventions, and to capture wider system effects, but these are not widely applied. Future priorities for economic analysis should be to produce cost-effectiveness evidence and to increase our understanding of how service interventions affect, and are affected by, the care system.