Bridging the gap between health and non-health investments: moving from cost-effectiveness analysis to a return on investment approach across sectors of economy
Bridging the gap between health and non-health investments: moving from cost-effectiveness analysis to a return on investment approach across sectors of economy
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DOI：
10.1007/s10754-008-9032-4
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发表时间：
2008-06-01
期刊：
影响因子：
--
通讯作者：
Sendi, Pedram
中科院分区：
文献类型：
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作者：
Sendi, Pedram
当从治疗方案菜单中选择时，最佳治疗取决于目标函数和模型的假设。成本效益分析的经典决策规则可以通过两个不同的目标函数来制定：（i）在预算约束下最大化健康结果或（ii）在事后确定预算的情况下最大化干预的净效益。我们建议一个更一般的目标函数（三）最大限度地提高投资回报率，从现有的资源，考虑健康和非健康投资。回报石油投资方法允许从社会或亚社会的角度调整对替代性非健康投资放弃的利益的分析。我们发现，在非健康投资的正回报的存在下，决策者的意愿支付每单位的效果为治疗方案需要高于其增量成本效益比被认为是具有成本效益的。
When choosing from a menu of treatment alternatives, the optimal treatment depends on the objective function and the assumptions of the model. The classical decision rule of cost-effectiveness analysis may be formulated via two different objective functions: (i) maximising health outcomes subject to the budget constraint or (ii) maximising the net benefit of the intervention with the budget being determined ex post. We Suggest a more general objective function of (iii) maximising return on investment from available resources with consideration of health and non-health investments. The return oil investment approach allows to adjust the analysis for the benefits forgone by alternative non-health investments from a societal or subsocietal perspective. We show that in the presence of positive returns on non-health investments the decision-maker's willingness to pay per unit of effect for a treatment program needs to be higher than its incremental cost-effectiveness ratio to be considered cost-effective.