Francesco Paolucci1, Emmanouil Mentzakis2, Thierry Defechereux2, Louis W Niessen2. 1. Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Perth, WA, Australia & School of Economics, University of Bologna, Bologna, Italy, Economics Department, University of Southampton, Southampton, UK, Independent Consultant and Centre for Applied Health Research, Liverpool School of Tropical Medicine, L3 5PQ Liverpool and Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA f.paolucci@murdoch.edu.au. 2. Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Perth, WA, Australia & School of Economics, University of Bologna, Bologna, Italy, Economics Department, University of Southampton, Southampton, UK, Independent Consultant and Centre for Applied Health Research, Liverpool School of Tropical Medicine, L3 5PQ Liverpool and Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
Abstract
BACKGROUND: Macroeconomic growth in China enables significant progress in health care and public health. It faces difficult choices regarding access, quality and affordability, while dealing with the increasing burden of chronic diseases. Policymakers are pressured to make complex decisions while implementing health strategies. This study shows how this process could be structured and reports the specific equity and efficiency preferences among Chinese policymakers. METHODS: In total, 78 regional, provincial and national level policymakers with considerable experience participated in a discrete choice experiment, weighting the relative importance of six policy attributes describing equity and efficiency. Results from a conditional logistic model are presented for the six criteria, measuring the associated weights. Observed and unobserved heterogeneities were incorporated and tested in the model. Findings are used to give an example of ranking health interventions in relation to the present disease burden in China. RESULTS: In general, respondents showed strong preference for efficiency criteria i.e. total beneficiaries and cost-effectiveness as the most important attributes in decision making over equity criteria. Hence, priority interventions would be those conditions that are most prevalent in the country and cost least per health gain. CONCLUSION: Although efficiency criteria override equity ones, major health threats in China would be targeted. Multicriteria decision analysis makes explicit important trade-offs between efficiency and equity, leading to explicit, transparent and rational policy making. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine
BACKGROUND: Macroeconomic growth in China enables significant progress in health care and public health. It faces difficult choices regarding access, quality and affordability, while dealing with the increasing burden of chronic diseases. Policymakers are pressured to make complex decisions while implementing health strategies. This study shows how this process could be structured and reports the specific equity and efficiency preferences among Chinese policymakers. METHODS: In total, 78 regional, provincial and national level policymakers with considerable experience participated in a discrete choice experiment, weighting the relative importance of six policy attributes describing equity and efficiency. Results from a conditional logistic model are presented for the six criteria, measuring the associated weights. Observed and unobserved heterogeneities were incorporated and tested in the model. Findings are used to give an example of ranking health interventions in relation to the present disease burden in China. RESULTS: In general, respondents showed strong preference for efficiency criteria i.e. total beneficiaries and cost-effectiveness as the most important attributes in decision making over equity criteria. Hence, priority interventions would be those conditions that are most prevalent in the country and cost least per health gain. CONCLUSION: Although efficiency criteria override equity ones, major health threats in China would be targeted. Multicriteria decision analysis makes explicit important trade-offs between efficiency and equity, leading to explicit, transparent and rational policy making. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine
Authors: Suzana Karim; Benjamin M Craig; Caroline Vass; Catharina G M Groothuis-Oudshoorn Journal: Pharmacoeconomics Date: 2022-08-12 Impact factor: 4.558
Authors: Laura Wall; Madeleine Hinwood; Danielle Lang; Angela Smith; Samantha Bunzli; Philip Clarke; Peter F M Choong; Michelle M Dowsey; Francesco Paolucci Journal: BMJ Open Date: 2020-03-10 Impact factor: 2.692