Masih raised a good Q in yesterday’s class: whether cost-effectiveness analysts tend to select discrete, well-defined interventions for their analyses, rather than broader interventions, or whole service “platforms” such as a health clinic, a clinic system, or a hospital. I replied that I thought that this was probably true – they may be a tendency to focus on discrete services, if for no other reason than such a focus makes for a more tractable analysis. Upon reflection, I still think that’s true. However, the field is increasingly recognizing the issue. Dean Jamison, (Dean Jamison | UCSF Profiles) one of the leading light behind the Disease Control Priority Project, has been advocating for the analysis of “platforms” (e.g., clinics, hospitals) for service delivery rather than discrete services.
In past work I have done on the cost-effectiveness of essential surgery in developing countries I came across CEAs of hospitals, trauma centers and even surgery itself as a broad intervention.
I’ve attached four articles here for anyone who is interested in seeing how one might structure such analyses.