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Impact of Socioeconomic Differences on Distributional Cost-effectiveness Analysis.
Fan Yang1, Colin Angus2, Ana Duarte1
1Centre for Health Economics, University of York, UK.
Summary
Distributional cost-effectiveness analysis (DCEA) reveals how socioeconomic factors impact public health interventions. Accounting for these differences is crucial for accurately assessing effects on overall health and health inequality.
Area of Science:
- Public Health
- Health Economics
- Health Inequality Research
Background:
- Public health decision-makers require evaluations considering both overall health outcomes and health equity.
- Distributional cost-effectiveness analysis (DCEA) integrates health inequality into economic evaluations by analyzing group-specific parameters.
- Understanding the influence of socioeconomic differences on DCEA is vital for optimizing its application.
Purpose of the Study:
- To investigate how accounting for socioeconomic differences affects the assessment of public health interventions' impact on overall health and health inequality.
- To explore the value of DCEA in informing decision-makers about intervention impacts across diverse population groups.
Main Methods:
- Utilized two DCEA models for smoking cessation and alcohol misuse interventions.
- Incorporated national and local authority-level data on socioeconomic disparities in health and intervention uptake.
- Conducted scenario analyses to assess the sensitivity of DCEA results to variations in socioeconomic differences.
Main Results:
- Smoking cessation services were projected to increase overall health but worsen health inequality when all socioeconomic differences were included.
- Alcohol screening and brief interventions were projected to improve overall health and reduce inequality.
- Ignoring socioeconomic differences minimally affected overall health impact estimates but significantly altered health inequality assessments.
- Improving intervention coverage across socioeconomic groups yielded greater benefits than enhancing effectiveness.
Conclusions:
- DCEA is sensitive to the inclusion and nature of socioeconomic differences, particularly impacting health inequality estimations.
- Local-level socioeconomic data can alter the magnitude and sometimes the direction of estimated impacts on health inequality.
- Tailoring intervention coverage to maximize uptake across all population segments is a key strategy for improving health equity outcomes.
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