摘要:

AbstractThis paper, originally presented at the Institut d'Etudes Politiques de Paris, October 12, 1993, provides a perspective on envisioned changes in the practice of health economics. Foreseen changes include: (1) Study of more homogeneous units of analysis; (2) More original data gathering; (3) Increased attention to uncertainty and the supply of and demand for information; (4) Increased attention to institutional structures and their effects on economic behaviour; (5) Expansion of relevant tools for studying economic issues in health care; and (6) Continuing breakdown of disciplinary barriers between health economics and other disciplines. Of these, the two overriding features will be increased emphasis on understanding the many roles of uncertainty in economic behaviour, institutions, and outcomes in health care, and in the use of more and more ‘micro’ data to study these iss

ISSN:1057-9230    

DOI:10.1002/hec.4730040501

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractA structured methodological review of journal articles published in 1992 was undertaken to determine whether recently published economic evaluation studies deal systematically and comprehensively with uncertainty. Ninety three journal articles were identified from a range of searches including a computerised search of the MEDLINE CD‐Rom database. Articles were reviewed to determine how they had handled uncertainty in: a) data sources; b) generalisability; c) extrapolation; and d) analytic method. Articles were subsequently assessed to determine how they had represented this uncertainty in terms of the overall results of their analysis. Finally, studies were rated on the basis of their overall performance with respect to dealing systematically and comprehensively with uncertainty.Despite the numerous books and articles devoted to the appropriate methods to be employed by analysts conducting economic evaluation, 22 (24%) studies failed to consider uncertainty at all and 35 (38%) studies employed sensitivity analysis in a manner judged as inadequate. In all, 36 (39%) studies were judged to have given at least an adequate account of uncertainty with 13 (14%) of those judged to have provided a good account of uncertainty.Such disappointing results may reflect a general lack of detail in much of the methods literature concerning how sensitivity analysis should be applied and how results should be presented. Journal editors and readers of economic evaluation articles should acquaint themselves with the methods for handling uncertainty in order that they can critically evaluate the extent to which authors have allowed for uncertainties inherent in their analysi

ISSN:1057-9230    

DOI:10.1002/hec.4730040502

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractThe reduction of costs is becoming increasingly important in the medical field. The relevant topic of many clinical trials is not effectivenessper se, but rather cost‐effectiveness ratios. Surprisingly, no statistical tools for analyzing cost‐effectiveness ratios have been provided in the medical literature yet. This paper explains the gap in the literature, and provides a first technique for obtaining confidence intervals for cost‐effectiveness ratios. The technique does not use sophisticated tools to achieve maximal optimality, but seeks for tractability and ease of application while still satisfying all formal statistical require

ISSN:1057-9230    

DOI:10.1002/hec.4730040503

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractWe report the results of a postal survey of 150 editors of medical journals aimed at assessing editorial policy on peer‐review of economic studies. 70 editors (47%) responded to the anonymous questionnaire which contained six questions. 16 (23% or respondents) claimed to have an editorial policy, most claiming acceptance of ‘good evaluations’. Few (36%) had trained economists as referees and none had criteria or guidelines for peer‐reviewing economic studies. This situation helps to explain the variable quality of international economic literature. There is an urgent need to produce internationally accepted sets of guidelines for authors, editors and peer‐

ISSN:1057-9230    

DOI:10.1002/hec.4730040504

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractThe purpose of the paper is to measure and to compare performance of Belgian hospitals during the year 1991. In order to measure hospitals' efficiency, we estimate a resource function which is defined as the relationship between medical fees incurred in the treatment of a patient and the patient's pathology. From this relation, we construct a best practice reference frontier which defines the minimal hospital medical fees needed to treat the pathology. Efficiency is assessed relative to this resource frontier using a parametric stochastic method proposed by Schmidt and Sickles.9It appears that some specializations (circulatory system) involve more overproduction than others. Among the other results, we note that public hospitals are more efficient than the private ones and that university hospitals tend to use more resources than regular hospitals. The relationships between efficiency and different variables (location, size, costs and management) are finally analysed.

ISSN:1057-9230    

DOI:10.1002/hec.4730040505

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractThis paper examines the biases in estimating wage equations that may arise from measurement errors in various mental health indicators—two subjective proxies and one clinical assessment. The results suggest that a self‐reported measure based on whether the individual reported missing school or work for mental‐health‐related reasons leads to the smallest measurement error bias in the coefficients of the explanatory variables in an earnings equation. Two specific results lead to this conclusion. For one, the variance of the random component of its measurement error is the smallest among the three indicators leading to the least biased estimates of the impact of mental health on wages. Second, systematic reporting biases which vary with the non‐health regressors in a wage equation do not appear to exit in this measure. Consequently, this indicator follows the classical measurement error model. This implies that the coefficient estimates of the impact of non‐health variables are always improved, in the sense of having a smaller bias, when this mental health proxy is included in the regression.The measurement error in a self‐evaluation according to the scale of excellent, good, fair, or poor has the largest variance thus leading to a substantial understatement of the impact of mental health on earnings. This measure also contains significant reporting biases that vary with gender, race, and education—many of the non‐health regressors in a wage equation.The measurement error variance in the simulated diagnostic measure analyzed in this paper is also large. Thus this proxy will yield poor estimates of the impact of mental h

ISSN:1057-9230    

DOI:10.1002/hec.4730040506

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

ISSN:1057-9230    

DOI:10.1002/hec.4730040507

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

ISSN:1057-9230    

DOI:10.1002/hec.4730040508

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

ISSN:1057-9230    

DOI:10.1002/hec.4730040509

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

ISSN:1057-9230    

DOI:10.1002/hec.4730040510

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY