Asaria, Miqdad orcid.org/0000-0002-3538-4417, Griffin, Susan orcid.org/0000-0003-2188-8400, Cookson, Richard Andrew orcid.org/0000-0003-0052-996X et al. (2 more authors) (2013) Distributional cost-effectiveness analysis of health care programmes. Discussion Paper. CHE Research Paper . Centre for Health Economics, University of York , York, UK.
Abstract
This paper presents a case study application of a new methodological framework for undertaking distributional cost-effectiveness analysis (DCEA) to combine the objectives of maximising health and minimising unfair variation in health when evaluating population health interventions. The NHS Bowel Cancer Screening Programme (BCSP) introduced in 2006 is expected to improve population health on average but also to worsen population health inequalities associated with deprivation and ethnicity – a classic case of “intervention generated inequality”. We demonstrate the DCEA framework by examining two redesign options for the BCSP: (1) the introduction of an enhanced targeted reminder aimed at increasing screening uptake in deprived and ethnically diverse neighbourhoods and (2) the introduction of a basic universal reminder aimed at increasing screening uptake across the whole population. Our analysis indicates that the universal reminder is the strategy that maximises population health while the targeted reminder is the screening strategy that minimises unfair variation in health. The framework is used to demonstrate how these two objectives can be traded off against each other, and how alternative social value judgements influence the assessment of which strategy is best, including judgements about which dimensions of health variation are considered unfair and judgements about societal levels of inequality aversion.
Metadata
Item Type: | Monograph |
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Authors/Creators: |
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Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) > CHE Research Papers (York) |
Depositing User: | Pure (York) |
Date Deposited: | 26 Sep 2018 12:20 |
Last Modified: | 22 Jan 2025 00:32 |
Status: | Published |
Publisher: | Centre for Health Economics, University of York |
Series Name: | CHE Research Paper |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:136242 |
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