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At least 523 records · Page 29Linked to original sources
PubMed1994

Improving patient care: consequences for resource allocation.

Clinical trials have been designed to document the safety and efficacy of therapeutic interventions. However, data on the cost-effectiveness of new treatment regimens are increasingly required. This paper reviews economic evaluations performed on clinical trials in 3 different therapeutic areas: postinfarction prophylaxis, hypertension and heart failure. The data demonstrate that economic evaluations can provide important information which will aid decision making with respect to the cost-effectiveness of new treatment regimens. It is suggested that health economists and clinicians must work together to ensure that the limited health care budget is utilised to optimum effect.

Aged↗
PubMed1992

Community mental health and mental retardation services in the United States: a comparative study of resource allocation.

OBJECTIVE: Preliminary studies suggest that during the 1980s, spending for community mental retardation services in the United States may have grown much more rapidly than spending for community mental health. The primary objective of this study was to test empirically the validity of this thesis on a national basis. An additional objective was to determine why such a distinction in community spending patterns might have evolved nationally. METHOD: The study used states as the units of analysis and employed a five-factor hierarchical regression to predict variance in mental health and mental retardation spending. Factors were state size, state wealth, degree of federal assistance, state civil rights activity, and strength of consumer advocacy groups. Strong roles for the civil rights and consumer advocacy factors were hypothesized. A collateral opinion survey in the 10 states exhibiting the greatest within-state difference in community mental health and mental retardation spending was also completed. RESULTS: Community mental retardation spending grew nearly four times more rapidly than community mental health spending in the 1980s. The consumer advocacy and civil rights factors were strongly associated with spending for community mental retardation services in the states, but these factors did not predict spending for community mental health services. CONCLUSIONS: Study recommendations included strengthening mental health family and consumer advocacy groups in the states and promoting systematic exchange between the mental health and mental retardation fields through joint state planning initiatives, studies, and conferences. The need for Medicaid reform is a unifying theme in both the mental health and mental retardation fields.

Community Mental Health Services↗
PubMedDate not supplied

Willingness to pay for a quality-adjusted life year: implications for societal health care resource allocation.

BACKGROUND: Health-state preferences can be combined with willingness-to-pay (WTP) data to calculate WTP per quality-adjusted life year (QALY). The WTP/QALY ratios provide insight into societal valuations of expenditures for medical interventions. METHODS: The authors measured preferences for current health in 3 patient populations (N = 391) using standard gamble, time trade-off, visual analog scale, and WTP, then they calculated WTP/QALY ratios. The ratios were compared with several proposed cost/QALY cost-effectiveness ratio thresholds, the value-of-life literature, and with WTP/QALY ratios derived from published preference research. RESULTS: Mean WTP/QALY ratios ranged from 12,500 to 32,200 US dollars (2003 US dollars). All values were below most published cost-effectiveness ratio thresholds, below the ratio from a prototypic medical treatment covered by Medicare (i.e., renal dialysis), and below ratios from the value-of-life literature. The WTP/QALY ratios were similar to those calculated from published preference data for patients with symptomatic meno-pause, dentofacial deformities, asthma, or dermatologic disorders. CONCLUSIONS: WTP/QALY ratios calculated using preference data collected from diverse populations are lower than most proposed thresholds for determining what is "cost-effective." Current proposed cost-effectiveness ratio thresholds may overestimate the willingness of society to pay for medical interventions.

Adult↗
PubMed1999

Efficiency of home care: notes for an economic approach to resource allocation.

Home-delivered health-related services are not valued for themselves but are, rather, highly customized inputs that can be used in the production of several alternative "commodities" ultimately demanded by consumers. These valued commodities are the restoration, improvement, or maintenance of health and functional status that can be produced by home-delivered care (and by alternative services) and the everyday support of daily functioning at home. If we can describe how inputs into the production of these two commodities are allocated, it may be possible to make judgments about whether home-delivered care and other services would produce more value if they were allocated differently.

Cost-Benefit Analysis↗
PubMedDate not supplied

Planning and resource allocation in NHS colleges of health studies: 1.

The rapidly changing environment in which NHS colleges of health studies are now operating presents tremendous challenges to leaders in nurse education. Financial constraints brought about by the internal market and rapidly changing technology have resulted in complex funding arrangements and incompatible planning cycles. In the first of two articles, the funding of nurse education is explained and the recent changes in funding for NHS colleges are explained.

Decision Making, Organizational↗
PubMed1994

Health policy and craniofacial care: issues in resource allocation.

The distribution of health care services, including craniofacial services in the United States, is examined. The U.S. has a unique health care financing and organizational system in which persons are most commonly covered by health insurance as a benefit of their employment. Current estimates are that nearly 40 million Americans have no health insurance (Himmelstein et al., 1992). Approximately half of the uninsured persons are in low-wage employment that does not provide health insurance benefits nor allow them to qualify for Medicaid (Pepper Commission, 1990). Personal health care costs now exceed 11% of the U.S. gross domestic product, a significantly higher percentage than that found in other industrialized nations (Consumer Reports, 1990b). Within the current system, is health care distributed in a fair or moral manner? What are the effects of the allocation scheme? Possible changes in health care financing and delivery are examined and basic ethical and social issues associated with a changing U.S. health care delivery system are explored.

Adult↗