Lilford, Richard, Nepogodiev, Dmitri, Chilton, Peter J et al. (5 more authors) (2021) Methodological issues in economic evaluations of emergency transport systems in low-income and middle-income countries. BMJ Global health. ISSN 2059-7908
Abstract
A recent systematic review identified few papers on the economic evaluation of systems for emergency transport of acutely ill or injured patients. In addition, we found no articles dealing with the methodological challenges posed by such studies in low-income or middle-income countries. We therefore carried out an analysis of issues that are of particular salience to this important topic. This is an intellectual study in which we develop models, identify their limitations, suggest potential extensions to the models and discuss priorities for empirical studies to populate models. First, we develop a general model to calculate changes in survival contingent on the reduced time to treatment that an emergency transport system is designed to achieve. Second, we develop a model to estimate transfer times over an area that will be served by a proposed transfer system. Third, we discuss difficulties in obtaining parameters with which to populate the models. Fourth, we discuss costs, both direct and indirect, of an emergency transfer service. Fifth, we discuss the issue that outcomes other than survival should be considered and that the effects of a service are a weighted sum over all the conditions and severities for which the service caters. Lastly, based on the above work, we identify priorities for research. To our knowledge, this is the first study to identify and frame issues in the health economics of acute transfer systems and to develop models to calculate survival rates from basic parameters, such as time delay/survival relationships, that vary by intervention type and context.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. |
Keywords: | Cost-Benefit Analysis,Developing Countries,Humans,Income,Poverty |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) |
Depositing User: | Pure (York) |
Date Deposited: | 27 Sep 2021 10:50 |
Last Modified: | 27 Dec 2024 00:19 |
Published Version: | https://doi.org/10.1136/bmjgh-2020-004723 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1136/bmjgh-2020-004723 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:178536 |