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Economic evaluation of policy initiatives in the organisation and delivery of healthcare: a case study of gastroenterology endoscopy services.
- Source :
- Cost Effectiveness & Resource Allocation; 2014, Vol. 12 Issue 1, p1-20, 20p, 6 Charts
- Publication Year :
- 2014
-
Abstract
- Background Complex clinical interventions are increasingly subject to evaluation by randomised trial linked to economic evaluation. However evaluations of policy initiatives tend to eschew experimental designs in favour of interpretative perspectives which rarely allow the economic evaluation methods used in clinical trials. As evidence of the cost effectiveness of such initiatives is critical in informing policy, it is important to explore whether conventional economic evaluation methods apply to experimental evaluations of policy initiatives. Methods We used mixed methods based on a quasi-experimental design to evaluate a policy initiative whose aim was to expedite the modernisation of gastroenterology endoscopy services in England. We compared 10 sites which had received funding and support to modernise their endoscopy services with 10 controls. We collected data from five waves of patients undergoing endoscopy. The economic component of the study compared sites by levels of investment in modernisation and patients' use of health service resources, time off work and health related quality of life. Results We found no statistically significant difference between intervention and control sites in investment in modernisation or any patient outcome including health. Conclusions This study highlights difficulties in applying the rigour of a randomised trial and associated technique of economic evaluation to a policy initiative. It nevertheless demonstrates the feasibility of using this approach although further work is needed to demonstrate its generalisability in other applications. The present application shows that the small incentives offered to intervention sites did not enhance modernisation of gastroenterology endoscopy services or improve patient outcomes. [ABSTRACT FROM AUTHOR]
- Subjects :
- LABOR productivity
MEDICAL care use
MEDICAL care
INVESTMENTS
ANALYSIS of covariance
COMPARATIVE studies
CONFIDENCE intervals
COST effectiveness
EXECUTIVES
GASTROENTEROLOGY
HEALTH facilities
INTERVIEWING
LONGITUDINAL method
RESEARCH methodology
MEDICAL cooperation
ORGANIZATIONAL effectiveness
HEALTH outcome assessment
PROBABILITY theory
QUALITY assurance
QUESTIONNAIRES
RESEARCH
RESEARCH funding
CONTROL groups
ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 14787547
- Volume :
- 12
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Cost Effectiveness & Resource Allocation
- Publication Type :
- Academic Journal
- Accession number :
- 94930560
- Full Text :
- https://doi.org/10.1186/1478-7547-12-7