Biomedical subjects

Hans Keiding

Publications and source records attributed to Hans Keiding.

4 recordsLinked to original sources

PubMed2006

[Cost-effectiveness of treatment of high blood pressure with losartan in Denmark].

INTRODUCTION: The purpose of this analysis was to evaluate the cost-effectiveness of losartan compared with atenolol for the treatment of hypertension, both from the point of view of society and from that of the health care sector, based on data from the LIFE study. MATERIALS AND METHODS: The computations are based on a simple decision tree model, where the probability of stroke was obtained from the LIFE study, a double-blind, randomised clinical study of 9,193 patients with hypertensive left ventricle hypertrophy. RESULTS: The treatment of hypertension with losartan rather than atenolol entails a cost of DKK 19,668 per gained quality-adjusted life year (QALY), when only the cost of the health care sector is taken into account, and DKK 72,564 if all costs to society are included. CONCLUSION: The analysis shows that treatment with losartan is cost-effective even when the uncertainty in both data and economic evaluations is taken into account.

Adrenergic beta-Antagonists↗

PubMed2005

On the aggregation of health status measures.

In the present paper, we address the problem of finding conditions under which aggregation of individual health status measurements (e.g. QALYs) is meaningful in the sense that there is a universal unit of measurement for health. The problem is studied in a model where different aspects of health take the form of Lancasterian characteristics to be produced by the individuals using commodities obtained in the market. For a meaningful unit of measurement to exist, marginal rates of substitution between different aspects of health should not differ among individuals, and for this to happen in an equilibrium of the economy considered, certain assumptions of separability (of technology and/or preferences) must be satisfied. This means that universal measures of health will be meaningful only if there are not too many spillovers in achieving different aspects of health.

Denmark↗

PubMed2004

Cost-effectiveness with multiple outcomes.

In a large number of situations, activities in health care have to be measured in terms of outcome and cost. However, the cases where outcome is fully captured by a single measure are rather few, so that one uses some index for outcome, computed by weighing together several outcome measures using subjective and somewhat arbitrary weights. In the paper we propose an approach to cost-effectiveness analysis where such artificial aggregation is avoided. This is achieved by assigning to each activity the weights which are the most favourable in a comparison with the other options available, so that activities which have a poor score in this method are guaranteed to be inferior. The method corresponds to applying Data envelopment analysis, known from the theory of productivity, to the context of health economic evaluations. The method is applied to an analysis of the cost-effectiveness of alternative health plans using data from the Medical Outcome Study (JAMA 1996; 276: 1039-1047), where outcome is measured as improvement in mental and physical health.

Cost-Benefit Analysis↗

PubMed2002

Alternative health insurance schemes: a welfare comparison.

In this paper, we present a simple model of health insurance with asymmetric information, where we compare two alternative ways of organizing the insurance market. Either as a competitive insurance market, where some risks remain uninsured, or as a compulsory scheme, where however, the level of reimbursement of loss is to be determined by majority decision. In a simple welfare comparison, the compulsory scheme may in certain environments yield a solution which is inferior to that obtained in the market. We further consider the situation where the compulsory scheme may be supplemented by voluntary competitive insurance; this situation turns out to be at least as good as either of the alternatives.

Actuarial Analysis↗