Uncertainty Analysis in Intervention Impact on Health Inequality for Resource Allocation Decisions
Simon Walker and
Additional contact information
Fan Yang: Centre for Health Economics, University of York, York, Yorkshire, UK
Ana Duarte: Centre for Health Economics, University of York, York, Yorkshire, UK
Susan Griffin: Centre for Health Economics, University of York, York, Yorkshire, UK
Medical Decision Making, 2021, vol. 41, issue 6, 653-666
Cost-effectiveness analysis, routinely used in health care to inform funding decisions, can be extended to consider impact on health inequality. Distributional cost-effectiveness analysis (DCEA) incorporates socioeconomic differences in model parameters to capture how an intervention would affect both overall population health and differences in health between population groups. In DCEA, uncertainty analysis can consider the decision uncertainty around on both impacts (i.e., the probability that an intervention will increase overall health and the probability that it will reduce inequality). Using an illustrative example assessing smoking cessation interventions (2 active interventions and a â€œno-interventionâ€ arm), we demonstrate how the uncertainty analysis could be conducted in DCEA to inform policy recommendations. We perform value of information (VOI) analysis and analysis of covariance (ANCOVA) to identify what additional evidence would add most value to the level of confidence in the DCEA results. The analyses were conducted for both national and local authority-level decisions to explore whether the conclusions about decision uncertainty based on the national-level estimates could inform local policy. For the comparisons between active interventions and â€œno intervention,â€ there was no uncertainty that providing the smoking cessation intervention would increase overall health but increase inequality. However, there was uncertainty in the direction of both impacts when comparing between the 2 active interventions. VOI and ANCOVA show that uncertainty in socioeconomic differences in intervention effectiveness and uptake contributes most to the uncertainty in the DCEA results. This suggests potential value of collecting additional evidence on intervention-related inequalities for this evaluation. We also found different levels of decision uncertainty between settings, implying that different types and levels of additional evidence are required for decisions in different localities.
Keywords: distributional cost-effectiveness analysis; economic evaluation; health inequality; public health; uncertainty analysis (search for similar items in EconPapers)
References: View references in EconPapers View complete reference list from CitEc
Citations: Track citations by RSS feed
Downloads: (external link)
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:41:y:2021:i:6:p:653-666
Access Statistics for this article
More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().