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A holistic approach to the economic evaluation of health programs using institutionalist methodology

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  • Jan, Stephen

Abstract

The paper examines possibilities for employing more holistic approaches to the evaluation of health care programs. It is argued that the reductionism of conventional forms of economic evaluation, where value (or benefit) is seen in terms of either health consequences or individuals' utility, can cause a number of aspects of such programs to be overlooked. As such, this imposes fairly strict limits on the capacity of economic evaluation to inform public policy. In contrast, institutionalist economic theory in common with the community development approach to health promotion is an area of research which acknowledges that change to the broader socio-political environment can be a source of value. It is suggested that this idea has, for instance, significance for the evaluation of indigenous health programs where notions of "cultural appropriateness" have strong influence over the effectiveness and acceptability of such programs. It is concluded that no one evaluative approach is appropriate in all situations and that a greater receptiveness to broader sources of social value can help to improve the way evaluations are conducted.

Suggested Citation

  • Jan, Stephen, 1998. "A holistic approach to the economic evaluation of health programs using institutionalist methodology," Social Science & Medicine, Elsevier, vol. 47(10), pages 1565-1572, November.
    • Handle: RePEc:eee:socmed:v:47:y:1998:i:10:p:1565-1572
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    Cited by:

    1. Jan, Stephen, 2003. "A perspective on the analysis of credible commitment and myopia in health sector decision making," Health Policy, Elsevier, vol. 63(3), pages 269-278, March.
    2. Philippe Batifoulier & John Latsis & Jacques Merchiers, 2010. "Les priorités de la prise en charge financière des soins. Une approche par la philosophie du besoin," EconomiX Working Papers 2010-2, University of Paris Nanterre, EconomiX.
    3. Jan, Stephen & Pronyk, Paul & Kim, Julia, 2008. "Accounting for institutional change in health economic evaluation: A program to tackle HIV/AIDS and gender violence in Southern Africa," Social Science & Medicine, Elsevier, vol. 66(4), pages 922-932, February.
    4. Stephen Jan, 2000. "Institutional considerations in priority setting: transactions cost perspective on PBMA," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 631-641, October.
    5. Blake J Angell & Janani Muhunthan & Michelle Irving & Sandra Eades & Stephen Jan, 2014. "Global Systematic Review of the Cost-Effectiveness of Indigenous Health Interventions," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-12, November.
    6. J. Robert Branston & Lauretta Rubini & Roger Sugden & James Wilson, 2006. "The healthy development of economies: A strategic framework for competitiveness in the health industry," Review of Social Economy, Taylor & Francis Journals, vol. 64(3), pages 301-329.
    7. Lidia Engel & Stirling Bryan & David G. T. Whitehurst, 2021. "Conceptualising ‘Benefits Beyond Health’ in the Context of the Quality-Adjusted Life-Year: A Critical Interpretive Synthesis," PharmacoEconomics, Springer, vol. 39(12), pages 1383-1395, December.

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