Monday, May 31, 2010

Inaugural Blog Post

I have decided to start blogging about strategies to research, compare, and increase the value in health care. What is value in health care? Value takes into account both the health outcomes and the costs necessary to achieve or sustain them. Value is often defined as a ratio of costs over benefits/effects (or the reciprocal). Another related term to value is efficiency: can a particular strategy achieve the same outcomes at lower costs? What if the health outcomes are much higher but so are the costs - is the additional investment justified given the current discussion that the growth of health care costs need to slow? And what if the health outcomes are much worse but the costs are way below the comparator strategy?

What qualifies me to blog about this topic? I am deeply interested in clinical comparative effectiveness: what are the health outcomes of various treatments, for example when you compare them "head-to-head", be it in a clinical trial or in a meta-analysis. Also, I have done some work in cost-effectiveness analysis (the economic dimension of comparative effectiveness) and am looking at how is it being used in different health care systems. Cost-effectiveness offers theoretically the best way to compare the (long-term) consequences of two or more different strategies compares. Often, decision-analytic models are used to project costs and effects (for example life years or quality-adjusted life years) over time. However, since putting this approach into practice means rationing, in practice the implementation of using cost-effectiveness analysis to make coverage decisions is often prevented by politics.

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I very much welcome comments to the individual blog posts (simply click on "comment") as well as directing me towards interesting material (contact me via my website-in-development, Thank you!


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