Approaches to Aggregation and Decision Making-A Health Economics Approach: An ISPOR Special Task Force Report [5].
Value Health
; 21(2): 146-154, 2018 02.
Article
em En
| MEDLINE
| ID: mdl-29477392
ABSTRACT
The fifth section of our Special Task Force report identifies and discusses two aggregation issues 1) aggregation of cost and benefit information across individuals to a population level for benefit plan decision making and 2) combining multiple elements of value into a single value metric for individuals. First, we argue that additional elements could be included in measures of value, but such elements have not generally been included in measures of quality-adjusted life-years. For example, we describe a recently developed extended cost-effectiveness analysis (ECEA) that provides a good example of how to use a broader concept of utility. ECEA adds two features-measures of financial risk protection and income distributional consequences. We then discuss a further option for expanding this approach-augmented CEA, which can introduce many value measures. Neither of these approaches, however, provide a comprehensive measure of value. To resolve this issue, we review a technique called multicriteria decision analysis that can provide a comprehensive measure of value. We then discuss budget-setting and prioritization using multicriteria decision analysis, issues not yet fully resolved. Next, we discuss deliberative processes, which represent another important approach for population- or plan-level decisions used by many health technology assessment bodies. These use quantitative information on CEA and other elements, but the group decisions are reached by a deliberative voting process. Finally, we briefly discuss the use of stated preference methods for developing "hedonic" value frameworks, and conclude with some recommendations in this area.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Avaliação da Tecnologia Biomédica
/
Orçamentos
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Avaliação de Resultados em Cuidados de Saúde
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Análise Custo-Benefício
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Gastos em Saúde
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Tomada de Decisões
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Atenção à Saúde
Tipo de estudo:
Health_economic_evaluation
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Health_technology_assessment
/
Prognostic_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article