Population-level cost-effectiveness of implementing evidence-based practices into routine care
Related Experiment Video
Updated: Apr 21, 2026
Operant Protocols for Assessing the Cost-benefit Analysis During Reinforced Decision Making by Rodents
Published on: September 10, 2018
John C Fortney1, Jeffrey M Pyne, James F Burgess
1Health Services Research and Development, Central Arkansas Veterans Healthcare System, North Little Rock, AR; South Central Mental Illness Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR; Department of Psychiatry, University of Arkansas for Medical Sciences, North Little Rock, AR.
Objective:
The objective of this research was to apply a new methodology (population-level cost-effectiveness analysis) to determine the value of implementing an evidence-based practice in routine care.
Data Sources/Study Setting:
Data are from sequentially conducted studies: a randomized controlled trial and an implementation trial of collaborative care for depression. Both trials were conducted in the same practice setting and population (primary care patients prescribed antidepressants).
Study Design:
The study combined results from a randomized controlled trial and a pre-post-quasi-experimental implementation trial.
Data Collection/Extraction Methods:
The randomized controlled trial collected quality-adjusted life years (QALYs) from survey and medication possession ratios (MPRs) from administrative data. The implementation trial collected MPRs and intervention costs from administrative data and implementation costs from survey.
Principal Findings:
In the randomized controlled trial, MPRs were significantly correlated with QALYs (p = .03). In the implementation trial, patients at implementation sites had significantly higher MPRs (p = .01) than patients at control sites, and by extrapolation higher QALYs (0.00188). Total costs (implementation, intervention) were nonsignificantly higher ($63.76) at implementation sites. The incremental population-level cost-effectiveness ratio was $33,905.92/QALY (bootstrap interquartile range -$45,343.10/QALY to $99,260.90/QALY).
Conclusions:
The methodology was feasible to operationalize and gave reasonable estimates of implementation value.
More Related Videos
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions
01:23Methods of Documentation V: CBE
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...