Med Decis Making - Cost-effectiveness on a local level: whether and when to adopt a new technology.

Tópicos

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Resumo

Cost-effectiveness analysis has become a widely accepted tool for decision making in health care. The standard textbook cost-effectiveness analysis focuses on whether to make the switch from an old or common practice technology to an innovative technology, and in doing so, it takes a global perspective. In this article, we are interested in a local perspective, and we look at the questions of whether and when the switch from old to new should be made. A new approach to cost-effectiveness from a local (e.g., a hospital) perspective, by means of a mathematical model for cost-effectiveness that explicitly incorporates time, is proposed. A decision rule is derived for establishing whether a new technology should be adopted, as well as a general rule for establishing when it pays to postpone adoption by 1 more period, and a set of decision rules that can be used to determine the optimal timing of adoption. Finally, a simple example is presented to illustrate our model and how it leads to optimal decision making in a number of cases.

Resumo Limpo

costeffect analysi becom wide accept tool decis make health care standard textbook costeffect analysi focus whether make switch old common practic technolog innov technolog take global perspect articl interest local perspect look question whether switch old new made new approach costeffect local eg hospit perspect mean mathemat model costeffect explicit incorpor time propos decis rule deriv establish whether new technolog adopt well general rule establish pay postpon adopt period set decis rule can use determin optim time adopt final simpl exampl present illustr model lead optim decis make number case

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