Economic Evaluations of Public Health Interventions a 公共卫生干预的经济学评价.pptVIP

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Economic Evaluations of Public Health Interventions a 公共卫生干预的经济学评价.ppt

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Operationalising Sens Capability Approach: An application in public health Dr Paula Lorgelly Health Economics Appraisal Team (HEAT) Public Health and Health Policy Outline of seminar Economic evaluations of public health interventions An example Sen’s Capability Approach Operationalising the approach as a means of measuring outcome Remaining challenges and future research Cost effective public health UK background, Wanless (2004) recommended using “a consistent framework … to evaluated the cost effectiveness of interventions initiatives across health care and public health” 2005 NICE’s remit expanded, now considers public health interventions Amended NICE reference case Their approach to methods states: … resources available in the health service and other available public funds Cost consequence analysis to supplement cost utility analysis where appropriate Challenges of producing NICE PH guidance Measuring benefit Population based interventions Equity vs. efficiency Economic perspective Time horizons Quality of evidence Cost effectiveness threshold Chalkidou et al (2008) Health Economics Challenges of applying standard approaches Methodological challenges of Attributing outcomes to interventions Measuring and valuing outcomes Incorporating equity considerations Identifying intersectoral costs and consequences Public Health Research Consortium, York Measuring and valuing outcomes QALYs are the reference case Preference for using the EQ5D No adjustment for equity QALYs have their benefits Public health vs health care interventions But does the QALY framework (or descriptive system) capture all relevant outcomes My (HEAT’s) involvement Section of Public Health and Health Policy Strong collaborations with the Medical Research Council Social and Public Health Sciences Unit (MRC SPHSU) Including a joint appointment (Liz Fenwick) Involved in evaluating a range of social and public health interventions Majority of which are complex Complex Public Health Interventio