21 research outputs found
Economic analysis of the health impacts of housing improvement studies: a systematic review
Background: Economic evaluation of public policies
has been advocated but rarely performed. Studies from a
systematic review of the health impacts of housing
improvement included data on costs and some economic
analysis. Examination of these data provides an
opportunity to explore the difficulties and the potential
for economic evaluation of housing.
Methods: Data were extracted from all studies included
in the systematic review of housing improvement which
had reported costs and economic analysis (n=29/45).
The reported data were assessed for their suitability to
economic evaluation. Where an economic analysis was
reported the analysis was described according to pre-set
definitions of various types of economic analysis used in
the field of health economics.
Results: 25 studies reported cost data on the
intervention and/or benefits to the recipients. Of these,
11 studies reported data which was considered
amenable to economic evaluation. A further four studies
reported conducting an economic evaluation. Three of
these studies presented a hybrid ‘balance sheet’
approach and indicated a net economic benefit
associated with the intervention. One cost-effectiveness
evaluation was identified but the data were unclearly
reported; the cost-effectiveness plane suggested that the
intervention was more costly and less effective than the
status quo.
Conclusions: Future studies planning an economic
evaluation need to (i) make best use of available data
and (ii) ensure that all relevant data are collected. To
facilitate this, economic evaluations should be planned
alongside the intervention with input from health
economists from the outset of the study. When
undertaken appropriately, economic evaluation provides
the potential to make significant contributions to
housing policy
A framework for developing an evidence-based, comprehensive tobacco control program
BACKGROUND: Tobacco control is an area where the translation of evidence into policy would seem to be straightforward, given the wealth of epidemiological, behavioural and other types of research available. Yet, even here challenges exist. These include information overload, concealment of key (industry-funded) evidence, contextualization, assessment of population impact, and the changing nature of the threat. METHODS: In the context of Israel's health targeting initiative, Healthy Israel 2020, we describe the steps taken to develop a comprehensive tobacco control strategy. We elaborate on the following: a) scientific issues influencing the choice of tobacco control strategies; b) organization of existing evidence of effectiveness of interventions into a manageable form, and c) consideration of relevant philosophical and political issues. We propose a framework for developing a plan and illustrate this process with a case study in Israel. RESULTS: Broad consensus exists regarding the effectiveness of most interventions, but current recommendations differ in the emphasis they place on different strategies. Scientific challenges include integration of complex and sometimes conflicting information from authoritative sources, and lack of estimates of population impact of interventions. Philosophical and political challenges include the use of evidence-based versus innovative policymaking, the importance of individual versus governmental responsibility, and whether and how interventions should be prioritized.The proposed framework includes: 1) compilation of a list of potential interventions 2) modification of that list based on local needs and political constraints; 3) streamlining the list by categorizing interventions into broad groupings of related interventions; together these groupings form the basis of a comprehensive plan; and 4) refinement of the plan by comparing it to existing comprehensive plans. CONCLUSIONS: Development of a comprehensive tobacco control plan is a complex endeavour, involving crucial decisions regarding intervention components. "Off the shelf" plans, which need to be adapted to local settings, are available from a variety of sources, and a multitude of individual recommendations are available. The proposed framework for adapting existing approaches to the local social and political climate may assist others planning for smoke-free societies. Additionally, this experience has implications for development of evidence-based health plans addressing other risk factors