IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v13y2004i12p1181-1190.html
   My bibliography  Save this article

Cost‐effectiveness with multiple outcomes

Author

Listed:
  • Jakob Bjørner
  • Hans Keiding

Abstract

In a large number of situations, activities in health care have to be measured in terms of outcome and cost. However, the cases where outcome is fully captured by a single measure are rather few, so that one uses some index for outcome, computed by weighing together several outcome measures using subjective and somewhat arbitrary weights. In the paper we propose an approach to cost‐effectiveness analysis where such artificial aggregation is avoided. This is achieved by assigning to each activity the weights which are the most favourable in a comparison with the other options available, so that activities which have a poor score in this method are guaranteed to be inferior. The method corresponds to applying Data envelopment analysis, known from the theory of productivity, to the context of health economic evaluations. The method is applied to an analysis of the cost‐effectiveness of alternative health plans using data from the Medical Outcome Study (JAMA 1996; 276: 1039–1047), where outcome is measured as improvement in mental and physical health. Copyright © 2004 John Wiley & Sons, Ltd.

Suggested Citation

  • Jakob Bjørner & Hans Keiding, 2004. "Cost‐effectiveness with multiple outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 13(12), pages 1181-1190, December.
    • Handle: RePEc:wly:hlthec:v:13:y:2004:i:12:p:1181-1190
    DOI: 10.1002/hec.900
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.900
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.900?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    2. Andrew H. Briggs & David E. Wonderling & Christopher Z. Mooney, 1997. "Pulling cost‐effectiveness analysis up by its bootstraps: A non‐parametric approach to confidence interval estimation," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 327-340, July.
    3. Daniel F. Heitjan & Alan J. Moskowitz & William Whang, 1999. "Problems with Interval Estimates of the Incremental Cost—Effectiveness Ratio," Medical Decision Making, , vol. 19(1), pages 9-15, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kankana Mukherjee & Rexford Santerre & Ning Jackie Zhang, 2010. "Explaining the efficiency of local health departments in the U.S.: an exploratory analysis," Health Care Management Science, Springer, vol. 13(4), pages 378-387, December.
    2. Nikki McCaffrey & Meera Agar & Janeane Harlum & Jonathon Karnon & David Currow & Simon Eckermann, 2015. "Better Informing Decision Making with Multiple Outcomes Cost-Effectiveness Analysis under Uncertainty in Cost-Disutility Space," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-19, March.
    3. Amado, Carla Alexandra da Encarnação Filipe & Santos, Sérgio Pereira dos, 2009. "Challenges for performance assessment and improvement in primary health care: The case of the Portuguese health centres," Health Policy, Elsevier, vol. 91(1), pages 43-56, June.
    4. Miguel A. Negrín & Francisco J. Vázquez‐Polo, 2006. "Bayesian cost‐effectiveness analysis with two measures of effectiveness: the cost‐effectiveness acceptability plane," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 363-372, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Daniel F. Heitjan & Alan J. Moskowitz & William Whang, 1999. "Bayesian estimation of cost‐effectiveness ratios from clinical trials," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 191-201, May.
    2. Daniel F. Heitjan & Huiling Li, 2004. "Bayesian estimation of cost‐effectiveness: an importance‐sampling approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 191-198, February.
    3. Daniel F. Heitjan, 2000. "Fieller's method and net health benefits," Health Economics, John Wiley & Sons, Ltd., vol. 9(4), pages 327-335, June.
    4. Franz R. Hahn, 2007. "Determinants of Bank Efficiency in Europe. Assessing Bank Performance Across Markets," WIFO Studies, WIFO, number 31499.
    5. repec:lan:wpaper:1115 is not listed on IDEAS
    6. Azarnoosh Kafi & Behrouz Daneshian & Mohsen Rostamy-Malkhalifeh, 2021. "Forecasting the confidence interval of efficiency in fuzzy DEA," Operations Research and Decisions, Wroclaw University of Science and Technology, Faculty of Management, vol. 31(1), pages 41-59.
    7. Costa, Marcelo Azevedo & Lopes, Ana Lúcia Miranda & de Pinho Matos, Giordano Bruno Braz, 2015. "Statistical evaluation of Data Envelopment Analysis versus COLS Cobb–Douglas benchmarking models for the 2011 Brazilian tariff revision," Socio-Economic Planning Sciences, Elsevier, vol. 49(C), pages 47-60.
    8. Kristiaan Kerstens & Ignace Van de Woestyne, 2018. "Enumeration algorithms for FDH directional distance functions under different returns to scale assumptions," Annals of Operations Research, Springer, vol. 271(2), pages 1067-1078, December.
    9. Ahmad, Usman, 2011. "Financial Reforms and Banking Efficiency: Case of Pakistan," MPRA Paper 34220, University Library of Munich, Germany.
    10. Bowlin, W. F., 1995. "A characterization of the financial condition of the United States' aerospace-defense industrial base," Omega, Elsevier, vol. 23(5), pages 539-555, October.
    11. Büschken, Joachim, 2009. "When does data envelopment analysis outperform a naïve efficiency measurement model?," European Journal of Operational Research, Elsevier, vol. 192(2), pages 647-657, January.
    12. Helmi Hammami & Thanh Ngo & David Tripe & Dinh-Tri Vo, 2022. "Ranking with a Euclidean common set of weights in data envelopment analysis: with application to the Eurozone banking sector," Annals of Operations Research, Springer, vol. 311(2), pages 675-694, April.
    13. Khanal, Aditya & Koirala, Krishna & Regmi, Madhav, 2016. "Do Financial Constraints Affect Production Efficiency in Drought Prone Areas? A Case from Indonesian Rice Growers," 2016 Annual Meeting, February 6-9, 2016, San Antonio, Texas 230087, Southern Agricultural Economics Association.
    14. Jahangoshai Rezaee, Mustafa & Jozmaleki, Mehrdad & Valipour, Mahsa, 2018. "Integrating dynamic fuzzy C-means, data envelopment analysis and artificial neural network to online prediction performance of companies in stock exchange," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 489(C), pages 78-93.
    15. Vuciterna, Rina & Thomsen, Michael & Popp, Jennie & Musliu, Arben, 2017. "Efficiency and Competitiveness of Kosovo Raspberry Producers," 2017 Annual Meeting, February 4-7, 2017, Mobile, Alabama 252770, Southern Agricultural Economics Association.
    16. Bogetoft, Peter & Nielsen, Kurt, 2003. "Yardstick Based Procurement Design In Natural Resource Management," 2003 Annual Meeting, August 16-22, 2003, Durban, South Africa 25910, International Association of Agricultural Economists.
    17. Singer, Marcos & Donoso, Patricio & Poblete, Francisco, 2002. "Semi-autonomous planning using linear programming in the Chilean General Treasury," European Journal of Operational Research, Elsevier, vol. 140(2), pages 517-529, July.
    18. Chai, Naijie & Zhou, Wenliang & Hu, Xinlei, 2022. "Safety evaluation of urban rail transit operation considering uncertainty and risk preference: A case study in China," Transport Policy, Elsevier, vol. 125(C), pages 267-288.
    19. Iris Arends & Ute Bültmann & Willem van Rhenen & Henk Groen & Jac J L van der Klink, 2013. "Economic Evaluation of a Problem Solving Intervention to Prevent Recurrent Sickness Absence in Workers with Common Mental Disorders," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-1, August.
    20. Fang, Lei, 2022. "Measuring and decomposing group performance under centralized management," European Journal of Operational Research, Elsevier, vol. 297(3), pages 1006-1013.
    21. Chih-HAI YANG & Leah WU & Hui-Lin LIN, 2010. "Analysis of total-factor cultivated land efficiency in China's agriculture," Agricultural Economics, Czech Academy of Agricultural Sciences, vol. 56(5), pages 231-242.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:13:y:2004:i:12:p:1181-1190. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.