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When Is It Worth Introducing a Quality Improvement Program? A Mathematical Model

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  • Afschin Gandjour
  • Karl Wilhelm Lauterbach

Abstract

Quality improvement programs must compete with other health care interventions for limited health care resources. The goal of the research presented here was to develop a model that portrays the mathematical relationship between the size of a quality deficit caused by the noncompliance of health professionals and the cost-effectiveness of a quality improvement program. The model allows the determination of the minimum size of a quality deficit for which it is worth introducinga quality improvement program. If a quality improvement program has already been implemented, the model can be used to define the quality threshold beyond which a reduction in quality becomes economically unattractive. An example consideringthe reduction of underuse in depression treatment demonstrates that an intervention with a favorable cost-effectiveness ratio may become economically unattractive once the costs for the implementation effort are considered.

Suggested Citation

  • Afschin Gandjour & Karl Wilhelm Lauterbach, 2003. "When Is It Worth Introducing a Quality Improvement Program? A Mathematical Model," Medical Decision Making, , vol. 23(6), pages 518-525, November.
    • Handle: RePEc:sae:medema:v:23:y:2003:i:6:p:518-525
    DOI: 10.1177/0272989X03258441
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    References listed on IDEAS

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    1. Dyfrig A. Hughes & Adrian Bagust & Alan Haycox & Tom Walley, 2001. "The impact of non‐compliance on the cost‐effectiveness of pharmaceuticals: a review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 10(7), pages 601-615, October.
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    Cited by:

    1. Afschin Gandjour, 2010. "A model to predict the cost‐effectiveness of disease management programs," Health Economics, John Wiley & Sons, Ltd., vol. 19(6), pages 697-715, June.
    2. Gandjour, Afschin & Stock, Stephanie, 2007. "A national hypertension treatment program in Germany and its estimated impact on costs, life expectancy, and cost-effectiveness," Health Policy, Elsevier, vol. 83(2-3), pages 257-267, October.
    3. Anke Richter & Patricia Thieda & Kylie Thaler & Gerald Gartlehner, 2011. "The impact of inclusion criteria in health economic assessments," Applied Health Economics and Health Policy, Springer, vol. 9(3), pages 139-148, May.
    4. Afschin Gandjour, 2010. "Investment in quality improvement: how to maximize the return," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 31-42, January.
    5. Afschin Gandjour, 2015. "A model to optimize investments in health technologies, quality of care and research," Applied Economics, Taylor & Francis Journals, vol. 47(20), pages 2031-2039, April.

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