Cycle‐network expansion plan in Oslo: Modeling cost‐effectiveness analysis and health equity impact

Lamu, Admassu Nadew; Norheim, Ole Frithjof; Gregersen, Fredrik Alexander; Barra, Mathias

doi:10.1002/hec.4435

Cited by 7 publications

(5 citation statements)

References 56 publications

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“…Before the introduction of medical equipment by medical institutions, the corresponding positioning work needs to be carried out. Different types of medical equipment can be compared, while the performance parameters of the same type of medical equipment also can be compared [ 21 ] to provide the guidance and references for the purchase of equipment by hospitals. In some cases, some medical equipment meets the requirements only because of one of the functions.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Life Cycle Cost Theory-Based Large Medical Equipment

Chang

Zhao

et al. 2022

Applied Bionics and Biomechanics

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The purpose of this study is to use the life cycle cost theory to analyze the efficiency of large medical equipment in hospitals, so as to implement life cycle cost (LCC) management and solve the current problems in hospitals. The analysis model of cost benefit of large medical equipment is established, and the cost-effectiveness of 4 large medical equipment between 2019 and 2021 is investigated and analyzed. In terms of the data in each information system of hospitals, the utilization of large medical equipment is quantitatively evaluated and analyzed by life cycle theory. The results show that the Revolution 256 row has the highest revenue of 113.29%. The annual depreciation of Signa 3.0 T HDxt is the highest, amounting to 4,160,000 yuan. However, there is lack of quality control and preventive maintenance of most equipment during use. The cost and benefit of large medical equipment in hospitals are analyzed, which demonstrates that Signa 3.0 T HDxt shows better effectiveness. Too high hospital warranty cost reflects the weak maintenance strength of hospital engineering technicians. The fundamental point of the maintenance and management of large medical equipment is to strengthen the performance evaluation of medical engineering technicians.

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Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Life Cycle Cost Theory-Based Large Medical Equipment

Chang

Zhao

et al. 2022

Applied Bionics and Biomechanics

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“…Comparably, Lamu at al. (2021) assessed the cost-effectiveness of expanding the current cycle network in Oslo by 100km at $3.5 million per km and an annual maintenance cost of 7% by developing a state-transition Markov model to simulate the impact of changes in cycling, and therefore overall physical activity levels, on four related diseases (cancer, coronary heart disease, stroke and type II diabetes) and associated costs and quality-adjusted life years [ 49 ]. Compared to no intervention, the 100km cycling expansion program was deemed cost-effective, at an incremental $16,575 per quality-adjusted life year gained.…”

Section: Discussionmentioning

confidence: 99%

“…importance and social value of reducing existing unfair and unjust health inequalities which could not be incorporated into this analysis. While a growing body of empirical literature has been generated [64], a recent example is the study by Lamu et al (2021), for which the researchers developed a decision-analytic model to assess the cost-effectiveness of the intervention by socio-economic status and under what circumstances the intervention would reduce baseline inequality and increase social welfare.…”

Section: Plos Onementioning

confidence: 99%

How much behaviour change is required for the investment in cycling infrastructure to be sustainable? A break-even analysis

Candio

Frew

2023

PLoS ONE

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Background Active travel has gained traction among policy makers as a promising solution to physical inactivity. Returns on active travel investments, including cycling infrastructure, crucially rely on resulting improvements in population behaviours. Estimating the expected economic value that an additional regular cyclist will generate and being able to identify the behaviour change required at the population level to offset the intervention costs is important to inform future investment decisions. Methods The WHO’s Health Economic Assessment Tool was employed to conduct a break-even analysis. A case study methodology was used which focused on a real-world construction project of a separated cycleway in the UK. The economic assessment considered physical activity benefits, air pollution, crash risk and carbon emissions in monetary terms. An iterative computational approach was applied to identify the behaviour change (cycling) requirements, and corresponding benefits valued using international dollars, to break even on the investment costs. Sensitivity analyses were conducted to assess robustness of the base-case results. Results Over a ten-year time horizon, an additional regular cyclist (i.e., someone cycling most days of the week) was found to generate $798 (₤533) per annum (international dollars). An additional 267 regular cyclists per km were required to break even on the construction of the new separated cycleway. Estimates were particularly sensitive to variations to age, cycling volume and evaluation time horizon. Conclusions Policymakers planning to invest in cycling infrastructure should consider using these reproducible, order-of-magnitude estimates to complement the more comprehensive transport appraisal and budget allocation processes. This would ensure that, when considering its health-related economic benefits, the investment is justifiable on economic sustainability grounds.

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“…We note as well that our illustrative model—like many CEAs—focused on population-level averages. For researchers and policy-makers who are interested in variability among patient sub-populations or across clinical settings, our proposed framework can be applied to distributional cost-effectiveness analyses [ 79 – 81 ] or to CEAs that stratify patients or health service delivery settings in some other manner [ 82 , 83 ]. In such models, researchers may see variations in the alignment of perspectives (e.g., weakly congruent, consistent) within sub-groups of patients and/or settings.…”

Section: Discussionmentioning

confidence: 99%

Framework for determining the optimal course of action when efficiency and affordability measures differ by perspective in cost-effectiveness analysis—with an illustrative case of HIV treatment in Mozambique

Corlis,

Zhu,

Macul

et al. 2023

Cost Eff Resour Alloc

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Background Cost-effectiveness analysis (CEA) is a standard tool for evaluating health programs and informing decisions about resource allocation and prioritization. Most CEAs evaluating health interventions in low- and middle-income countries adopt a health sector perspective, accounting for resources funded by international donors and country governments, while often excluding out-of-pocket expenditures and time costs borne by program beneficiaries. Even when patients’ costs are included, a companion analysis focused on the patient perspective is rarely performed. We view this as a missed opportunity. Methods We developed methods for assessing intervention affordability and evaluating whether optimal interventions from the health sector perspective also represent efficient and affordable options for patients. We mapped the five different patterns that a comparison of the perspective results can yield into a practical framework, and we provided guidance for researchers and decision-makers on how to use results from multiple perspectives. To illustrate the methodology, we conducted a CEA of six HIV treatment delivery models in Mozambique. We conducted a Monte Carlo microsimulation with probabilistic sensitivity analysis from both patient and health sector perspectives, generating incremental cost-effectiveness ratios for the treatment approaches. We also calculated annualized patient costs for the treatment approaches, comparing the costs with an affordability threshold. We then compared the cost-effectiveness and affordability results from the two perspectives using the framework we developed. Results In this case, the two perspectives did not produce a shared optimal approach for HIV treatment at the willingness-to-pay threshold of 0.3 × Mozambique’s annual GDP per capita per DALY averted. However, the clinical 6-month antiretroviral drug distribution strategy, which is optimal from the health sector perspective, is efficient and affordable from the patient perspective. All treatment approaches, except clinical 1-month distributions of antiretroviral drugs which were standard before Covid-19, had an annual cost to patients less than the country’s annual average for out-of-pocket health expenditures. Conclusion Including a patient perspective in CEAs and explicitly considering affordability offers decision-makers additional insights either by confirming that the optimal strategy from the health sector perspective is also efficient and affordable from the patient perspective or by identifying incongruencies in value or affordability that could affect patient participation.

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Cycle‐network expansion plan in Oslo: Modeling cost‐effectiveness analysis and health equity impact

Cited by 7 publications

References 56 publications

Cost-Effectiveness of Life Cycle Cost Theory-Based Large Medical Equipment

Cost-Effectiveness of Life Cycle Cost Theory-Based Large Medical Equipment

How much behaviour change is required for the investment in cycling infrastructure to be sustainable? A break-even analysis

Framework for determining the optimal course of action when efficiency and affordability measures differ by perspective in cost-effectiveness analysis—with an illustrative case of HIV treatment in Mozambique

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