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[PMID]:29401495
[Au] Autor:Stewart SA; Clive AO; Maskell NA; Penz E
[Ad] Endereço:Dalhousie University, Halifax, NS, Canada.
[Ti] Título:Evaluating quality of life and cost implications of prophylactic radiotherapy in mesothelioma: Health economic analysis of the SMART trial.
[So] Source:PLoS One;13(2):e0190257, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The SMART trial is a UK-based, multicentre RCT comparing prophylactic radiotherapy and symptom-based (deferred) radiotherapy in 203 patients with Malignant Pleural Mesothelioma who had undergone large bore pleural interventions. Using costs and quality of life data collected alongside the clinical trial, we will estimate the cost-effectiveness of prophylactic radiotherapy compared to deferred radiotherapy over a 1-year period. METHODS: Healthcare utilization and costs were captured during the trial. Utility weights produced by the EQ-5D questionnaire were used to determine quality-adjusted life-years (QALY) gained. The incremental cost-effectiveness ratio was calculated over the one-year trial period. RESULTS: Costs were similar in the immediate and deferred radiotherapy groups: £5480.40 (SD = £7040; n = 102) and £5461.40 (SD = £7770; n = 101) respectively. There was also no difference in QALY: 0.498 (95% CI: [0.45, 0.547]) in the prophylactic radiotherapy group versus 0.525 (95% CI: [0.471, 0.580]) in the deferred group. At a willingness to pay threshold of £30,000/QALY there was only a 24% chance that prophylactic radiotherapy was cost-effective compared to deferred radiotherapy. CONCLUSIONS: There was no significant effect of prophylactic radiotherapy on quality of life in the intervention group, nor was there any discernable decrease in healthcare costs. There is little evidence to suggest that prophylactic radiotherapy is a cost-effective intervention in this population. TRIAL REGISTRATION: ISRCTN72767336 with ISRCTN.
[Mh] Termos MeSH primário: Economia Médica
Custos de Cuidados de Saúde
Mesotelioma/radioterapia
Qualidade de Vida
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Análise Custo-Benefício
Feminino
Seres Humanos
Masculino
Meia-Idade
Radioterapia/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190257


  2 / 7123 MEDLINE  
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[PMID]:28388739
[Au] Autor:Schumm-Draeger PM
[Ti] Título:[Medicine Before Economics - DGIM is Focusing on Discussion of Values].
[Ti] Título:Medizin vor Ökonomie ­ DGIM rückt Wertediskussion in den Fokus..
[So] Source:Dtsch Med Wochenschr;142(7):461, 2017 Apr.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Mh] Termos MeSH primário: Assistência à Saúde/organização & administração
Economia Médica/organização & administração
[Mh] Termos MeSH secundário: Alemanha
Seres Humanos
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-121497


  3 / 7123 MEDLINE  
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[PMID]:28355231
[Au] Autor:Hope SF; Webster J; Trieu K; Pillay A; Ieremia M; Bell C; Snowdon W; Neal B; Moodie M
[Ad] Endereço:Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Burwood, Victoria, Australia.
[Ti] Título:A systematic review of economic evaluations of population-based sodium reduction interventions.
[So] Source:PLoS One;12(3):e0173600, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To summarise evidence describing the cost-effectiveness of population-based interventions targeting sodium reduction. METHODS: A systematic search of published and grey literature databases and websites was conducted using specified key words. Characteristics of identified economic evaluations were recorded, and included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. RESULTS: Twenty studies met the study inclusion criteria and received a full paper review. Fourteen studies were identified as full economic evaluations in that they included both costs and benefits associated with an intervention measured against a comparator. Most studies were modelling exercises based on scenarios for achieving salt reduction and assumed effects on health outcomes. All 14 studies concluded that their specified intervention(s) targeting reductions in population sodium consumption were cost-effective, and in the majority of cases, were cost saving. Just over half the studies (8/14) were assessed as being of 'excellent' reporting quality, five studies fell into the 'very good' quality category and one into the 'good' category. All of the identified evaluations were based on modelling, whereby inputs for all the key parameters including the effect size were either drawn from published datasets, existing literature or based on expert advice. CONCLUSION: Despite a clear increase in evaluations of salt reduction programs in recent years, this review identified relatively few economic evaluations of population salt reduction interventions. None of the studies were based on actual implementation of intervention(s) and the associated collection of new empirical data. The studies universally showed that population-based salt reduction strategies are likely to be cost effective or cost saving. However, given the reliance on modelling, there is a need for the effectiveness of new interventions to be evaluated in the field using strong study designs and parallel economic evaluations.
[Mh] Termos MeSH primário: Doenças Cardiovasculares/economia
Análise Custo-Benefício
Modelos Estatísticos
Serviços Preventivos de Saúde/economia
Sódio na Dieta/economia
[Mh] Termos MeSH secundário: Doenças Cardiovasculares/etiologia
Doenças Cardiovasculares/mortalidade
Doenças Cardiovasculares/prevenção & controle
Economia Médica
Seres Humanos
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Sódio na Dieta/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Sodium, Dietary)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0173600


  4 / 7123 MEDLINE  
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[PMID]:28292484
[Au] Autor:Hoogendoorn M; Feenstra TL; Asukai Y; Briggs AH; Hansen RN; Leidl R; Risebrough N; Samyshkin Y; Wacker M; Rutten-van Mölken MP
[Ad] Endereço:Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, The Netherlands. Electronic address: hoogendoorn@imta.eur.nl.
[Ti] Título:External Validation of Health Economic Decision Models for Chronic Obstructive Pulmonary Disease (COPD): Report of the Third COPD Modeling Meeting.
[So] Source:Value Health;20(3):397-403, 2017 Mar.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To validate outcomes of presently available chronic obstructive pulmonary disease (COPD) cost-effectiveness models against results of two large COPD trials-the 3-year TOwards a Revolution in COPD Health (TORCH) trial and the 4-year Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT) trial. METHODS: Participating COPD modeling groups simulated the outcomes for the placebo-treated groups of the TORCH and UPLIFT trials using baseline characteristics of the trial populations as input. Groups then simulated treatment effectiveness by using relative reductions in annual decline in lung function and exacerbation frequency observed in the most intensively treated group compared with placebo as input for the models. Main outcomes were (change in) total/severe exacerbations and mortality. Furthermore, the absolute differences in total exacerbations and quality-adjusted life-years (QALYs) were used to approximate the cost per exacerbation avoided and the cost per QALY gained. RESULT: Of the six participating models, three models reported higher total exacerbation rates than observed in the TORCH trial (1.13/patient-year) (models: 1.22-1.48). Four models reported higher rates than observed in the UPLIFT trial (0.85/patient-year) (models: 1.13-1.52). Two models reported higher mortality rates than in the TORCH trial (15.2%) (models: 20.0% and 30.6%) and the UPLIFT trial (16.3%) (models: 24.8% and 36.0%), whereas one model reported lower rates (9.8% and 12.1%, respectively). Simulation of treatment effectiveness showed that the absolute reduction in total exacerbations, the gain in QALYs, and the cost-effectiveness ratios did not differ from the trials, except for one model. CONCLUSIONS: Although most of the participating COPD cost-effectiveness models reported higher total exacerbation rates than observed in the trials, estimates of the absolute treatment effect and cost-effectiveness ratios do not seem different from the trials in most models.
[Mh] Termos MeSH primário: Broncodilatadores/economia
Análise Custo-Benefício/métodos
Análise Custo-Benefício/normas
Fluticasona/economia
Doença Pulmonar Obstrutiva Crônica/economia
Xinafoato de Salmeterol/economia
Brometo de Tiotrópio/economia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Broncodilatadores/uso terapêutico
Simulação por Computador
Tomada de Decisões
Economia Médica
Feminino
Fluticasona/uso terapêutico
Seres Humanos
Masculino
Meia-Idade
Modelos Econométricos
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
Doença Pulmonar Obstrutiva Crônica/mortalidade
Anos de Vida Ajustados por Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Xinafoato de Salmeterol/uso terapêutico
Brometo de Tiotrópio/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Bronchodilator Agents); 6EW8Q962A5 (Salmeterol Xinafoate); CUT2W21N7U (Fluticasone); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE


  5 / 7123 MEDLINE  
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[PMID]:28292475
[Au] Autor:Crown W; Buyukkaramikli N; Thokala P; Morton A; Sir MY; Marshall DA; Tosh J; Padula WV; Ijzerman MJ; Wong PK; Pasupathy KS
[Ad] Endereço:OptumLabs, Boston, MA, USA. Electronic address: William.Crown@optum.com.
[Ti] Título:Constrained Optimization Methods in Health Services Research-An Introduction: Report 1 of the ISPOR Optimization Methods Emerging Good Practices Task Force.
[So] Source:Value Health;20(3):310-319, 2017 Mar.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Providing health services with the greatest possible value to patients and society given the constraints imposed by patient characteristics, health care system characteristics, budgets, and so forth relies heavily on the design of structures and processes. Such problems are complex and require a rigorous and systematic approach to identify the best solution. Constrained optimization is a set of methods designed to identify efficiently and systematically the best solution (the optimal solution) to a problem characterized by a number of potential solutions in the presence of identified constraints. This report identifies 1) key concepts and the main steps in building an optimization model; 2) the types of problems for which optimal solutions can be determined in real-world health applications; and 3) the appropriate optimization methods for these problems. We first present a simple graphical model based on the treatment of "regular" and "severe" patients, which maximizes the overall health benefit subject to time and budget constraints. We then relate it back to how optimization is relevant in health services research for addressing present day challenges. We also explain how these mathematical optimization methods relate to simulation methods, to standard health economic analysis techniques, and to the emergent fields of analytics and machine learning.
[Mh] Termos MeSH primário: Assistência à Saúde/economia
Economia Médica
Alocação de Recursos/economia
[Mh] Termos MeSH secundário: Comitês Consultivos
Orçamentos
Tomada de Decisões
Pesquisa sobre Serviços de Saúde
Seres Humanos
Modelos Econométricos
Alocação de Recursos/métodos
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE


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[PMID]:28260345
[Au] Autor:Xiao J; Sun JF; Wang QQ; Qi X; Yao HY
[Ad] Endereço:Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
[Ti] Título:[Health economic evaluation reporting guideline and application status].
[So] Source:Zhonghua Yu Fang Yi Xue Za Zhi;51(3):276-280, 2017 Mar 06.
[Is] ISSN:0253-9624
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Using the guidelines of health economic evaluation reporting is conducive to regulating the contents of this reporting, improving the quality of studies into health economics evaluation. This article summarized the history of the guidelines and specified the instrument used to study " Quality of Health Economic Studies (QHES)" and the checklist about Consolidated Health Economics Evaluation Reporting Standards (CHEERS)-the two specific evaluation contents in this guideline, the article also introduced its present application status of the guideline and its pros and cons. The checklist of CHEERS emphasized the evaluation of this report, while QHES instrument focused on quantitative evaluation on the quality of economic studies. Despite different emphasis, the two guides are actually mutually complemented.
[Mh] Termos MeSH primário: Lista de Checagem
Economia Médica
Guias como Assunto
[Mh] Termos MeSH secundário: Análise Custo-Benefício
Seres Humanos
Padrões de Referência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170306
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-9624.2017.03.016


  7 / 7123 MEDLINE  
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[PMID]:28212957
[Au] Autor:Zafari Z; Bryan S; Sin DD; Conte T; Khakban R; Sadatsafavi M
[Ad] Endereço:Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: zafar.zafari@ubc.ca.
[Ti] Título:A Systematic Review of Health Economics Simulation Models of Chronic Obstructive Pulmonary Disease.
[So] Source:Value Health;20(1):152-162, 2017 Jan.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many decision-analytic models with varying structures have been developed to inform resource allocation in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To review COPD models for their adherence to the best practice modeling recommendations and their assumptions regarding important aspects of the natural history of COPD. METHODS: A systematic search of English articles reporting on the development or application of a decision-analytic model in COPD was performed in MEDLINE, Embase, and citations within reviewed articles. Studies were summarized and evaluated on the basis of their adherence to the Consolidated Health Economic Evaluation Reporting Standards. They were also evaluated for the underlying assumptions about disease progression, heterogeneity, comorbidity, and treatment effects. RESULTS: Forty-nine models of COPD were included. Decision trees and Markov models were the most popular techniques (43 studies). Quality of reporting and adherence to the guidelines were generally high, especially in more recent publications. Disease progression was modeled through clinical staging in most studies. Although most studies (n = 43) had incorporated some aspects of COPD heterogeneity, only 8 reported the results across subgroups. Only 2 evaluations explicitly considered the impact of comorbidities. Treatment effect had been mostly modeled (20) as both reduction in exacerbation rate and improvement in lung function. CONCLUSIONS: Many COPD models have been developed, generally with similar structural elements. COPD is highly heterogeneous, and comorbid conditions play an important role in its burden. These important aspects, however, have not been adequately addressed in most of the published models.
[Mh] Termos MeSH primário: Modelos Econômicos
Doença Pulmonar Obstrutiva Crônica/economia
[Mh] Termos MeSH secundário: Comorbidade
Análise Custo-Benefício
Técnicas de Apoio para a Decisão
Progressão da Doença
Economia Médica
Fidelidade a Diretrizes
Seres Humanos
Cadeias de Markov
Guias de Prática Clínica como Assunto
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Qualidade de Vida
Anos de Vida Ajustados por Qualidade de Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170530
[Lr] Data última revisão:
170530
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170219
[St] Status:MEDLINE


  8 / 7123 MEDLINE  
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[PMID]:28152099
[Au] Autor:Vemer P; Al MJ; Oppe M; Rutten-van Mölken MP
[Ad] Endereço:Institute for Medical Technology Assessment (iMTA), Erasmus University, Rotterdam, The Netherlands.
[Ti] Título:Mix and match. A simulation study on the impact of mixed-treatment comparison methods on health-economic outcomes.
[So] Source:PLoS One;12(2):e0171292, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Decision-analytic cost-effectiveness (CE) models combine many parameters, often obtained after meta-analysis. AIM: We compared different methods of mixed-treatment comparison (MTC) to combine transition and event probabilities derived from several trials, especially with respect to health-economic (HE) outcomes like (quality adjusted) life years and costs. METHODS: Trials were drawn from a simulated reference population, comparing two of four fictitious interventions. The goal was to estimate the CE between two of these. The amount of heterogeneity between trials was varied in scenarios. Parameter estimates were combined using direct comparison, MTC methods proposed by Song and Puhan, and Bayesian generalized linear fixed effects (GLMFE) and random effects models (GLMRE). Parameters were entered into a Markov model. Parameters and HE outcomes were compared with the reference population using coverage, statistical power, bias and mean absolute deviation (MAD) as performance indicators. Each analytical step was repeated 1,000 times. RESULTS: The direct comparison was outperformed by the MTC methods on all indicators, Song's method yielded low bias and MAD, but uncertainty was overestimated. Puhan's method had low bias and MAD and did not overestimate uncertainty. GLMFE generally had the lowest bias and MAD, regardless of the amount of heterogeneity, but uncertainty was overestimated. GLMRE showed large bias and MAD and overestimated uncertainty. Song's and Puhan's methods lead to the least amount of uncertainty, reflected in the shape of the CE acceptability curve. GLMFE showed slightly more uncertainty. CONCLUSIONS: Combining direct and indirect evidence is superior to using only direct evidence. Puhan's method and GLMFE are preferred.
[Mh] Termos MeSH primário: Economia Médica
Avaliação de Processos e Resultados (Cuidados de Saúde)/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Viés
Doença Crônica/economia
Doença Crônica/terapia
Feminino
Custos de Cuidados de Saúde/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Modelos Teóricos
Anos de Vida Ajustados por Qualidade de Vida
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0171292


  9 / 7123 MEDLINE  
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[PMID]:28152012
[Au] Autor:Iribarren SJ; Cato K; Falzon L; Stone PW
[Ad] Endereço:University of Washington, Department of Biobehavioral Nursing and Health Informatics, School of Nursing, Seattle, Washington, United States of America.
[Ti] Título:What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions.
[So] Source:PLoS One;12(2):e0170581, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited. In this systematic review the body of evidence related to economic evaluations of mHealth interventions is assessed and summarized. METHODS: Seven electronic bibliographic databases, grey literature, and relevant references were searched. Eligibility criteria included original articles, comparison of costs and consequences of interventions (one categorized as a primary mHealth intervention or mHealth intervention as a component of other interventions), health and economic outcomes and published in English. Full economic evaluations were appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and The PRISMA guidelines were followed. RESULTS: Searches identified 5902 results, of which 318 were examined at full text, and 39 were included in this review. The 39 studies spanned 19 countries, most of which were conducted in upper and upper-middle income countries (34, 87.2%). Primary mHealth interventions (35, 89.7%), behavior change communication type interventions (e.g., improve attendance rates, medication adherence) (27, 69.2%), and short messaging system (SMS) as the mHealth function (e.g., used to send reminders, information, provide support, conduct surveys or collect data) (22, 56.4%) were most frequent; the most frequent disease or condition focuses were outpatient clinic attendance, cardiovascular disease, and diabetes. The average percent of CHEERS checklist items reported was 79.6% (range 47.62-100, STD 14.18) and the top quartile reported 91.3-100%. In 29 studies (74.3%), researchers reported that the mHealth intervention was cost-effective, economically beneficial, or cost saving at base case. CONCLUSIONS: Findings highlight a growing body of economic evidence for mHealth interventions. Although all studies included a comparison of intervention effectiveness of a health-related outcome and reported economic data, many did not report all recommended economic outcome items and were lacking in comprehensive analysis. The identified economic evaluations varied by disease or condition focus, economic outcome measurements, perspectives, and were distributed unevenly geographically, limiting formal meta-analysis. Further research is needed in low and low-middle income countries and to understand the impact of different mHealth types. Following established economic reporting guidelines will improve this body of research.
[Mh] Termos MeSH primário: Análise Custo-Benefício/métodos
Economia Médica/estatística & dados numéricos
Telemedicina/economia
Telemedicina/estatística & dados numéricos
[Mh] Termos MeSH secundário: Telefone Celular/utilização
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0170581


  10 / 7123 MEDLINE  
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[PMID]:28148292
[Au] Autor:Hernandez-Villafuerte K; Sussex J; Robin E; Guthrie S; Wooding S
[Ad] Endereço:Office of Health Economics, London, United Kingdom. khernandez-villafuerte@ohe.org.
[Ti] Título:Economies of scale and scope in publicly funded biomedical and health research: evidence from the literature.
[So] Source:Health Res Policy Syst;15(1):3, 2017 Feb 02.
[Is] ISSN:1478-4505
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Publicly funded biomedical and health research is expected to achieve the best return possible for taxpayers and for society generally. It is therefore important to know whether such research is more productive if concentrated into a small number of 'research groups' or dispersed across many. METHODS: We undertook a systematic rapid evidence assessment focused on the research question: do economies of scale and scope exist in biomedical and health research? In other words, is that research more productive per unit of cost if more of it, or a wider variety of it, is done in one location? We reviewed English language literature without date restriction to the end of 2014. To help us to classify and understand that literature, we first undertook a review of econometric literature discussing models for analysing economies of scale and/or scope in research generally (not limited to biomedical and health research). RESULTS: We found a large and disparate literature. We reviewed 60 empirical studies of (dis-)economies of scale and/or scope in biomedical and health research, or in categories of research including or overlapping with biomedical and health research. This literature is varied in methods and findings. At the level of universities or research institutes, studies more often point to positive economies of scale than to diseconomies of scale or constant returns to scale in biomedical and health research. However, all three findings exist in the literature, along with inverse U-shaped relationships. At the level of individual research units, laboratories or projects, the numbers of studies are smaller and evidence is mixed. Concerning economies of scope, the literature more often suggests positive economies of scope than diseconomies, but the picture is again mixed. The effect of varying the scope of activities by a research group was less often reported than the effect of scale and the results were more mixed. CONCLUSIONS: The absence of predominant findings for or against the existence of economies of scale or scope implies a continuing need for case by case decisions when distributing research funding, rather than a general policy either to concentrate funding in a few centres or to disperse it across many.
[Mh] Termos MeSH primário: Pesquisa Biomédica/economia
Pesquisa sobre Serviços de Saúde/economia
[Mh] Termos MeSH secundário: Custos e Análise de Custo
Economia Médica
Seres Humanos
Modelos Econômicos
Setor Público
Apoio à Pesquisa como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE
[do] DOI:10.1186/s12961-016-0167-3



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