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How Much Does It Cost to Change the Behavior of Health Professionals? A Mathematical Model and an Application to Academic Detailing

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  • Afschin Gandjour

    (Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany, afschin.gandjour@medizin.uni-koeln.de)

  • Karl Wilhelm Lauterbach

    (Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany)

Abstract

Several strategies have shown to be effective at enhancing the implementation of research findings in daily practice. These implementation strategies improve the delivery of preventive or therapeutic care by successfully educating health professionals. On the other hand, little is known about the costs of these implementation strategies. The goal of this article is to present a mathematical model that predicts implementation costs by using published data. As an important feature, the model portrays the relationship between the degree of treatment underuse and implementation costs. Two application examples of outreach programs for the prevention of stroke and coronary disease analyze the relevance of implementation costs with respect to the cost-effectiveness ratio and total costs. They demonstrate that implementation costs may have little impact on the cost-effectiveness ratio but may nevertheless be relevant to a 3rd-party payer who needs to stay within the budget and ensure that care is provided to a large underserved population. The model and its consideration of implementation costs may contribute to a more efficient use of health care resources.

Suggested Citation

  • Afschin Gandjour & Karl Wilhelm Lauterbach, 2005. "How Much Does It Cost to Change the Behavior of Health Professionals? A Mathematical Model and an Application to Academic Detailing," Medical Decision Making, , vol. 25(3), pages 341-347, May.
  • Handle: RePEc:sae:medema:v:25:y:2005:i:3:p:341-347
    DOI: 10.1177/0272989X05276858
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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. 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.
    4. Ties Hoomans & Johan L. Severens & Silvia M. A. A. Evers & Andre J. H. A. Ament, 2009. "Value for Money in Changing Clinical Practice: Should Decisions about Guidelines and Implementation Strategies Be Made Sequentially or Simultaneously?," Medical Decision Making, , vol. 29(2), pages 207-216, March.

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