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A review of health care models for coronary heart disease interventions

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  • K. Cooper

    ()

  • S. Brailsford
  • R. Davies
  • J. Raftery
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    Abstract

    This article reviews models for the treatment of coronary heart disease (CHD). Whereas most of the models described were developed to assess the cost effectiveness of different treatment strategies, other models have also been used to extrapolate clinical trials, for capacity and resource planning, or to predict the future population with heart disease. In this paper we investigate the use of modelling techniques in relation to different types of health intervention, and we discuss the assumptions and limitations of these approaches. Many of the models reviewed in this paper use decision tree models for acute or short term interventions, and Markov or state transition models for chronic or long term interventions. Discrete event simulation has, however, been used for more complex whole system models, and for modelling resource-constrained interventions and operational planning. Nearly all of the studies in our review used cohort-based models rather than population based models, and therefore few models could estimate the likely total costs and benefits for a population group. Most studies used de novo purpose built models consisting of only a small number of health states. Models of the whole disease system were less common. The model descriptions were often incomplete. We recommend that the reporting of model structure, assumptions and input parameters is more explicit, to reduce the risk of biased reporting and ensure greater confidence in the model results. Copyright Springer Science + Business Media, LLC 2006

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    File URL: http://hdl.handle.net/10.1007/s10729-006-9996-x
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    Bibliographic Info

    Article provided by Springer in its journal Health Care Management Science.

    Volume (Year): 9 (2006)
    Issue (Month): 4 (November)
    Pages: 311-324

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    Handle: RePEc:kap:hcarem:v:9:y:2006:i:4:p:311-324

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    Web page: http://www.springerlink.com/link.asp?id=101767

    Related research

    Keywords: Health care; Model; Decision tree; Markov; Discrete event simulation; Economic evaluation; Coronary heart disease;

    References

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    1. Davies, Ruth & Roderick, Paul & Raftery, James, 2003. "The evaluation of disease prevention and treatment using simulation models," European Journal of Operational Research, Elsevier, vol. 150(1), pages 53-66, October.
    2. Gerard, Karen & Smoker, Irenie & Seymour, Janelle, 1999. "Raising the quality of cost-utility analyses: lessons learnt and still to learn," Health Policy, Elsevier, vol. 46(3), pages 217-238, March.
    3. Mark Sculpher & Elisabeth Fenwick & Karl Claxton, 2000. "Assessing Quality in Decision Analytic Cost-Effectiveness Models: A Suggested Framework and Example of Application," PharmacoEconomics, Springer Healthcare | Adis, vol. 17(5), pages 461-477.
    4. Davies, R & Davies, HTO, 1994. "Modelling patient flows and resource provision in health systems," Omega, Elsevier, vol. 22(2), pages 123-131, March.
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