|Type of paper:||Essay|
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Intervention. Unruh and Spetz (2012) try to establish whether CBA can be used in establishing different health interventions such as preventive interventions (including vaccines, maternal and neonatal interventions, environmental alterations, injury preventions, and intermediate host control among others), therapeutic interventions (treating infectious diseases, surgery, and treatment of chronic diseases), and other different forms of interventions that improve quality of life of patients and human beings.
Cost Analysis Method of Intervention. Unruh and Spetz (2012) explain that with cost-benefit analysis (CBA), total benefits minus total costs are used in comparison with net benefits. The authors explain that this method cannot be used in the evaluation of healthcare interventions and treatments since it is impossible to measure the value placed on human life in monetary terms. They add CBA has difficulties in assessing monetarily some of the impacts of the project, such as the value of time, human life, and environmental costs.
The Effectiveness of the Cost Analysis Method. Uhruz and Spetz (2012) are correct by stating that CBA cannot be used in health interventions especially when it comes to benefits such as saved human lives and also in the case of the conservation of ecosystems. This is because they have no price in the market that reflect their value or because these prices do not contemplate the social value of the good (Park, Jit, & Wu, 2018). Secondly, the economic valuation of environmental impacts, essential to carry out the CBA, involves various practical difficulties that, in general, tend to underestimate environmental benefits and costs. Particularly, when it comes to valuing biodiversity and its components, it is common to ignore the benefits they generate, and even in many cases, the existence of important components of said biodiversity or the services provided by ecosystems is not recognized (Park et al., 2018). The economic valuation attributed to biodiversity and its components will tend to be very limited (Phelps, Madhavan, Rappuoli, Colwell, & Fineberg, 2017). When this information is transferred to the CBA, the environmental costs and benefits tend to be underestimated.
Cost-Effectiveness Analysis (CEA)
Intervention. Bauer (2010) did a CEA evaluating quality outcomes, malpractice costs, and salary costs of NPs compared to physicians. Bauer (2010) referred to the Cochrane Collection which cites 36 studies indicating similar patient outcomes between physicians and NPs. Based on results from the NP Data Bank, NPs do not increase liability claims or costs with a rate of claims declining lower than the physicians (Bauer, 2010, p. 230).
Cost Analysis Method of Intervention. Cost-Effectiveness Analysis (CEA) evaluates the most effective approach to provide interventions or services within a specific project, program or policy change by assessing non-monetary elements as well as costs (Napper & Newland, 2002). Unruh and Spetz (2012) discuss CEA in terms of which intervention or process will provide the best results for the best costs (p. 159).
The Effectiveness of the Cost Analysis Method. CEA is appropriate for the health intervention project because of several reasons. It makes it possible to compare policies, programs or projects among themselves and to compare several alternatives, in particular, to choose the one that is best able to obtain a given result for the lowest cost (Nair, Jehan, Albejaidi, & Pasha, 2017). CEA is used to evaluate screening campaigns for certain cancers where the cost of setting up screening is calculated in the numerator, and the cost of avoided cancers is the denominator. CEA takes into account quality of life adjustments for a given set of treatments or strategies (Nair et al., 2017).
Bauer, J. C. (2010). Nurse practitioners as an underutilized resource for health reform: Evidence-based demonstrations of cost-effectiveness. Journal of American Academy of Nurse Practitioners, 22(4), 228-231. https://doi.org/10.1111/j.1745-7599.2010.00498.x
Nair, K. S., Jehan, M., Albejaidi, F., & Pasha, S. A. (2017). Cost-effectiveness analysis for decision making in health care-concept, relevance, and methodological challenges. International Journal of Community Medicine and Public Health, 4(7), 2212-2218. http://dx.doi.org/10.18203/2394-6040.ijcmph20172808
Napper, M., & Newland, J., (2002). Health economics information resources: A self-study course. Retrieved from: http://www.nlm.nih.gov/nichsr/edu/healthcon/
Park, M., Jit, M., & Wu, J. T. (2018). Cost-benefit analysis of vaccination: a comparative analysis of eight approaches for valuing changes to mortality and morbidity risks. BMC Medicine, 16(1), 139. https://doi.org/10.1186/s12916-018-1130-7
Phelps, C., Madhavan, G., Rappuoli, R., Colwell, R., & Fineberg, H. (2017). Beyond cost-effectiveness: Using systems analysis for infectious disease preparedness. Vaccine, 35, A46-A49. https://doi.org/10.1016/j.vaccine.2016.08.090
Ramos-Barron, M. A., Vazquez-Rodriguez, J. A., & Garcia-Garrido, A. B. (2014). Cost-benefit analysis of a population-based cervical cancer screening program designed for Cantabria. Semergen, 40(6), 296-304. https://doi.org/10.1016/j.semerg.2013.11.006
Unruh, L., & Spetz, J., (2012). A primer on health economics. In D. Mason, J. Leavitt, & M. Chaffee (Eds.), Policy and politics in nursing and health care (pp. 153-161). St. Louis, MO: Elsevier Saunders.
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