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Using Cost‐Effectiveness Estimates From Survey Data To Guide Commissioning: An Application To Home Care

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  • Julien Forder
  • Juliette Malley
  • Ann‐Marie Towers
  • Ann Netten

Abstract

The aim is to describe and trial a pragmatic method to produce estimates of the incremental cost‐effectiveness of care services from survey data. The main challenge is in estimating the counterfactual; that is, what the patient's quality of life would be if they did not receive that level of service. A production function method is presented, which seeks to distinguish the variation in care‐related quality of life in the data that is due to service use as opposed to other factors. A problem is that relevant need factors also affect the amount of service used and therefore any missing factors could create endogeneity bias. Instrumental variable estimation can mitigate this problem. This method was applied to a survey of older people using home care as a proof of concept. In the analysis, we were able to estimate a quality‐of‐life production function using survey data with the expected form and robust estimation diagnostics. The practical advantages with this method are clear, but there are limitations. It is computationally complex, and there is a risk of misspecification and biased results, particularly with IV estimation. One strategy would be to use this method to produce preliminary estimates, with a full trial conducted thereafter, if indicated. Copyright © 2013 John Wiley & Sons, Ltd.

Suggested Citation

  • Julien Forder & Juliette Malley & Ann‐Marie Towers & Ann Netten, 2014. "Using Cost‐Effectiveness Estimates From Survey Data To Guide Commissioning: An Application To Home Care," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 979-992, August.
    • Handle: RePEc:wly:hlthec:v:23:y:2014:i:8:p:979-992
    DOI: 10.1002/hec.2973
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    References listed on IDEAS

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    Cited by:

    1. Joanna Coast & Philip Kinghorn & Paul Mitchell, 2015. "The Development of Capability Measures in Health Economics: Opportunities, Challenges and Progress," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(2), pages 119-126, April.
    2. Helen Weatherly & Rita Faria & Bernard Van den Berg & Mark Sculpher & Peter O’Neill & Kay Nolan & Julie Glanville & Jaana Isojarvi & Erin Baragula & Mary Edwards, 2017. "Scoping review on social care economic evaluation methods," Working Papers 150cherp, Centre for Health Economics, University of York.
    3. Trukeschitz, Birgit & Hajji, Assma & Kieninger, Judith & Malley, Juliette & Linnosmaa, Issmo & Forder, Julien, 2021. "Investigating factors influencing quality-of-life effects of home care services in Austria, England, and Finland: a comparative analysis," LSE Research Online Documents on Economics 106222, London School of Economics and Political Science, LSE Library.
    4. Julien Forder & Florin Vadean & Stacey Rand & Juliette Malley, 2018. "The impact of long‐term care on quality of life," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 43-58, March.
    5. Wei Yang & Julien Forder & Olena Nizalova, 2017. "Measuring the productivity of residential long-term care in England: methods for quality adjustment and regional comparison," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(5), pages 635-647, June.
    6. Francesco Longo & Karl Claxton & James Lomas & Stephen Martin, 2020. "Does public long-term care expenditure improve care-related quality of life in England?," Working Papers 172cherp, Centre for Health Economics, University of York.
    7. Bernard Bensaid & Solen Croiset & Robert J. Gary-Bobo, 2022. "Economies of Density, Team Synergies and Unobserved Heterogeneity: A Study of Home Care Services," CESifo Working Paper Series 9864, CESifo.
    8. Francesco Longo & Karl Claxton & James Lomas & Stephen Martin, 2021. "Does public long‐term care expenditure improve care‐related quality of life of service users in England?," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2561-2581, September.

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