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A model to correct for short‐run inefficiencies in economic evaluations in healthcare

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  • Gijs Van de Wetering
  • Willem H. Woertman
  • Eddy M. M. Adang

Abstract

Important assumptions that underlie cost‐effectiveness analysis (CEA) are that production technologies are convex and that production processes always perform at constant returns to scale. However, in the short run these assumptions are likely to be violated. Therefore, CEAs might overestimate cost‐effectiveness in the short run. To come up with a more precise cost‐effectiveness outcome, we present a model that is able to correct the long‐run incremental net benefit (INB) for short‐run inefficiencies. This provides decision makers with a more realistic view of the expected efficiency gains. This model starts by determining the initial efficiency losses inflicted by inflexible resources. Then the model is made dynamic in order to adjust the efficiency losses by allowing for refilling and writing off freed capacity. Finally, the model calculates the length of the short‐run time frame in which such efficiency losses exist, and a correction term with which the usual long‐run INB should be adjusted to account for short‐run inefficiencies. The model is applied to two cases: dialysis and digitizing a radiography department. The dialysis case shows moderate short‐run efficiency losses while in the radiography case short‐run efficiency losses are sufficiently large to cause a switch in cost‐effectiveness from favorable to inefficient in the short run. Copyright © 2011 John Wiley & Sons, Ltd.

Suggested Citation

  • Gijs Van de Wetering & Willem H. Woertman & Eddy M. M. Adang, 2012. "A model to correct for short‐run inefficiencies in economic evaluations in healthcare," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 270-281, March.
  • Handle: RePEc:wly:hlthec:v:21:y:2012:i:3:p:270-281
    DOI: 10.1002/hec.1705
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453, Decembrie.
    2. Tone, Kaoru & Sahoo, Biresh K., 2003. "Scale, indivisibilities and production function in data envelopment analysis," International Journal of Production Economics, Elsevier, vol. 84(2), pages 165-192, May.
    3. Walter Briec & Kristiaan Kerstens & Philippe Venden Eeckaut, 2004. "Non-convex Technologies and Cost Functions: Definitions, Duality and Nonparametric Tests of Convexity," Journal of Economics, Springer, vol. 81(2), pages 155-192, February.
    4. Adang, Eddy M.M. & Wensing, Michel, 2008. "Economic barriers to implementation of innovations in health care: Is the long run-short run efficiency discrepancy a paradox?," Health Policy, Elsevier, vol. 88(2-3), pages 236-242, December.
    5. Adang, Eddy & Voordijk, Leo & Jan van der Wilt, Gert & Ament, Andre, 2005. "Cost-effectiveness analysis in relation to budgetary constraints and reallocative restrictions," Health Policy, Elsevier, vol. 74(2), pages 146-156, October.
    6. de Wit, G.Ardine & Ramsteijn, Paul G & de Charro, Frank Th, 1998. "Economic evaluation of end stage renal disease treatment," Health Policy, Elsevier, vol. 44(3), pages 215-232, June.
    7. Eddy Adang, 2008. "Economic evaluation of innovative technologies in health care should include a short-run perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(4), pages 381-384, November.
    8. Smet, Mike, 2002. "Cost characteristics of hospitals," Social Science & Medicine, Elsevier, vol. 55(6), pages 895-906, September.
    9. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2008. "The Value of Implementation and the Value of Information: Combined and Uneven Development," Medical Decision Making, , vol. 28(1), pages 21-32, January.
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    Cited by:

    1. van Baal, Pieter & Morton, Alec & Severens, Johan L., 2018. "Health care input constraints and cost effectiveness analysis decision rules," Social Science & Medicine, Elsevier, vol. 200(C), pages 59-64.

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