Econometric methods for evaluating the cost-effectiveness of health care interventions using observational data

<p>This thesis explores the use of observational microdata in cost-effectiveness analysis. The application of econometric methods adjusting for selection bias is first reviewed and critically appraised in the economic evaluation literature using a structured template. Limitations of identified...

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Bibliographic Details
Main Author: Rovithis, D
Other Authors: Fitzpatrick, R
Format: Thesis
Language:English
Published: 2014
Subjects:
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author Rovithis, D
author2 Fitzpatrick, R
author_facet Fitzpatrick, R
Rovithis, D
author_sort Rovithis, D
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description <p>This thesis explores the use of observational microdata in cost-effectiveness analysis. The application of econometric methods adjusting for selection bias is first reviewed and critically appraised in the economic evaluation literature using a structured template. Limitations of identified studies include lack of good quality evidence regarding the performance of different analytical approaches; inadequate assessment of the sensitivity of their results to violations of fundamental assumptions or variations to crucial estimator parameters; failure to combine the cost and effectiveness outcomes in a summary measure; and no consideration of stochastic uncertainty for the purpose of evaluating cost-effectiveness. Data from the Birthplace national cohort study are used in an attempt to address these limitations in the context of an empirical comparison of estimators relying on regression, matching, as well as the propensity score. It is argued that although these methods cannot address the potential impact of unobservable confounding, a novel approach to bias-corrected matching, combining entropy balancing with seemingly unrelated regression, still has the potential to offer important advantages in terms of analytical robustness. The net economic benefit is proposed as a straightforward way to exploit the strengths of rigorous econometric methodology in the development of reliable and informative cost-effectiveness analyses.</p>
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spelling oxford-uuid:4138e3c6-8939-48ae-b98e-f42728be57582022-03-26T14:42:16ZEconometric methods for evaluating the cost-effectiveness of health care interventions using observational dataThesishttp://purl.org/coar/resource_type/c_db06uuid:4138e3c6-8939-48ae-b98e-f42728be5758Public HealthEconomicsEconometricsHealth and health policyEnglishOxford University Research Archive - Valet2014Rovithis, DFitzpatrick, RPetrou, SWilkinson, A<p>This thesis explores the use of observational microdata in cost-effectiveness analysis. The application of econometric methods adjusting for selection bias is first reviewed and critically appraised in the economic evaluation literature using a structured template. Limitations of identified studies include lack of good quality evidence regarding the performance of different analytical approaches; inadequate assessment of the sensitivity of their results to violations of fundamental assumptions or variations to crucial estimator parameters; failure to combine the cost and effectiveness outcomes in a summary measure; and no consideration of stochastic uncertainty for the purpose of evaluating cost-effectiveness. Data from the Birthplace national cohort study are used in an attempt to address these limitations in the context of an empirical comparison of estimators relying on regression, matching, as well as the propensity score. It is argued that although these methods cannot address the potential impact of unobservable confounding, a novel approach to bias-corrected matching, combining entropy balancing with seemingly unrelated regression, still has the potential to offer important advantages in terms of analytical robustness. The net economic benefit is proposed as a straightforward way to exploit the strengths of rigorous econometric methodology in the development of reliable and informative cost-effectiveness analyses.</p>
spellingShingle Public Health
Economics
Econometrics
Health and health policy
Rovithis, D
Econometric methods for evaluating the cost-effectiveness of health care interventions using observational data
title Econometric methods for evaluating the cost-effectiveness of health care interventions using observational data
title_full Econometric methods for evaluating the cost-effectiveness of health care interventions using observational data
title_fullStr Econometric methods for evaluating the cost-effectiveness of health care interventions using observational data
title_full_unstemmed Econometric methods for evaluating the cost-effectiveness of health care interventions using observational data
title_short Econometric methods for evaluating the cost-effectiveness of health care interventions using observational data
title_sort econometric methods for evaluating the cost effectiveness of health care interventions using observational data
topic Public Health
Economics
Econometrics
Health and health policy
work_keys_str_mv AT rovithisd econometricmethodsforevaluatingthecosteffectivenessofhealthcareinterventionsusingobservationaldata