Visualising value for money in public health interventions
PHE ePoster Library. Leigh-Hunt N. Sep 13, 2016; 137881; 251
Nick Leigh-Hunt
Nick Leigh-Hunt
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Abstract
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Abstract Background: The Socio-Technical-Allocation-of-Resources (STAR) tool is an approach to informing value for money analysis of clinical services, using a series of stakeholder workshops to identify benefits. Recent financial challenges present an opportunity to adapt the tool for prioritisation of public health programmes.Methods: A modified STAR approach was used by firstly identifying costs and local service activity for all interventions within commissioned public health programmes. Secondly, benefits were identified by searching the economic evaluation literature for QALY per person values. Consensus on how these QALY values applied to local services was obtained with local commissioners, with sensitivity analyses carried out to increase robustness of each estimate.Results: Local cost-benefit estimates could be made for most interventions, allowing comparison within and between programmes using visual methods. Weaknesses of the method were a variable evidence base, lack of clearly associated performance monitoring data, and disparate time horizons. Means of working round these problems included using population prevalences and utility states where intervention specific evidence was lacking, and subdivision of large contracts into specific intervention costs using staffing ratios.Conclusion: To our knowledge this is the first experimental use of the STAR approach across public health programmes, which proved useful in informing commissioning decisions, engaging public health staff in key health economic principles, and understanding the relative value of local public health interventions. Further similar approaches could improve robustness of the process and support use of the tool for visualising value for money in public health interventions
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