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Incorporating concerns for equal lifetime health in evaluations of public health programs

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  • Robberstad, Bjarne
  • Norheim, Ole F.

Abstract

Economic evaluations are increasingly common as evidence in priority setting decisions, but lack of quantification of equity impact represents a situation of asymmetric information that easily lead to discrepancies between stated preferences for distribution of health care and the preferences revealed in actual priority setting. We suggest Gini impact and Achievement Index methodology as tools that can be used to incorporate concerns for equal lifetime health in numerical evaluation of public health programs. In a case study from Tanzania we explore how these techniques may diminish this information asymmetry. By comparing a childhood vaccine with treatment of hypertension in adults, we show that concerns for equity in the distribution of healthy years can be captured with standard measures of inequality and combined with a maximization concern. This illustrative case from a low-income setting, where resources are insufficient to meet the needs of both patient groups, illustrates how quantification of equity impact may change priorities.

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  • Robberstad, Bjarne & Norheim, Ole F., 2011. "Incorporating concerns for equal lifetime health in evaluations of public health programs," Social Science & Medicine, Elsevier, vol. 72(10), pages 1711-1716, May.
  • Handle: RePEc:eee:socmed:v:72:y:2011:i:10:p:1711-1716
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    References listed on IDEAS

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    Cited by:

    1. Richard Cookson & Andrew Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin, 2016. "Fairer decisions, better health for all: Health equity and cost-effectiveness analysis," Working Papers 135cherp, Centre for Health Economics, University of York.
    2. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39.
    3. Lane, Haylee & Sarkies, Mitchell & Martin, Jennifer & Haines, Terry, 2017. "Equity in healthcare resource allocation decision making: A systematic review," Social Science & Medicine, Elsevier, vol. 175(C), pages 11-27.
    4. Ngalesoni, Frida N. & Ruhago, George M. & Mori, Amani T. & Robberstad, Bjarne & Norheim, Ole F., 2016. "Equity impact analysis of medical approaches to cardiovascular diseases prevention in Tanzania," Social Science & Medicine, Elsevier, vol. 170(C), pages 208-217.

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