The diagonal approach: A theoretic framework for the economic evaluation of vertical and horizontal interventions in healthcare

Erin Kirwin, Rachel Meacock, Jeff Round and Matt Sutton

Social Science & Medicine, 2022, vol. 301, issue C

Abstract: The diagonal approach is a health system funding concept wherein vertical approaches targeting specific diseases are combined with horizontal approaches intended to strengthen health systems broadly. This taxonomy can also be used to classify health system interventions as either vertical or horizontal. Previous studies have used mathematical programming to evaluate horizontal interventions, but these models have not allowed concurrent evaluation of different types of horizontal interventions or captured spillovers and intertemporal effects. This paper aims to develop a theoretic framework for the diagonal approach. The framework is articulated through integer programming, maximizing health benefits given constraints by identifying the optimal set of both vertical and horizontal interventions to fund.

Keywords: Health system strengthening; Diagonal approach; Cost-effectiveness analysis; Economies of scope; Spillover effects; Horizontal healthcare programs; Vertical healthcare programs; Constraints (search for similar items in EconPapers)
Date: 2022
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DOI: 10.1016/j.socscimed.2022.114900

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