Entscheidungen bei „schwierigen” Kosteneffektivitätsrelationen am Beispiel eines klinischen Versuchs aus der Rehabilitation

Leidl, R. ; Jacobi, E.; Knabl, J. und Schweikert, B. (2006): Entscheidungen bei „schwierigen” Kosteneffektivitätsrelationen am Beispiel eines klinischen Versuchs aus der Rehabilitation. In: Gesundheitswesen, Bd. 68, Nr. 4: S. 249-256

Abstract

Purpose: Economic assessment of an additional psychological intervention in the rehabilitation of patients with chronic low-back pain and evaluation of results by decision makers.

Methods: Piggy-back cost-utility analysis of a randomised clinical trial, including a bootstrap analysis. Costs were measured by using the cost accounting systems of the rehabilitation clinics and by surveying patients. Health-related quality of life was measured using the EQ-5D. Implications of different representations of the decision problem and corresponding decision rules concerning the cost-effectiveness plane are discussed.

Results: As compared with the 126 patients of the control arm, the 98 patients in the intervention arm gained 3.5 days in perfect health on average as well as 1219 € cost saving. However, because of the uncertainty involved, the results of a bootstrap analysis cover all quadrants of the cost-effectiveness plane. Using maximum willingness-to-pay per effect unit gained, decision rules can be defined for parts of the cost-effectiveness plane. These have to be aggregated in a further valuation step.

Conclusions: Study results show that decisions on stochastic economic evaluation results may require an additional valuation step aggregating the various parts of the cost-effectiveness plane.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Betriebswirtschaft > Institut für Gesundheitsökonomie und Management im Gesundheitswesen
• Themengebiete: 300 Sozialwissenschaften > 330 Wirtschaft ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0941-3790
• Sprache: Englisch