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Multicriteria Decision Analysis for Including Health Interventions in the Universal Health Coverage Benefit Package in Thailand

Published on Sep 1, 2012in Value in Health5.037
· DOI :10.1016/j.jval.2012.06.006
Sitaporn Youngkong6
Estimated H-index: 6
(Health Intervention and Technology Assessment Program),
Rob Baltussen41
Estimated H-index: 41
(Radboud University Nijmegen Medical Centre)
+ 2 AuthorsYot Teerawattananon31
Estimated H-index: 31
(Health Intervention and Technology Assessment Program)
Sources
Abstract
Objectives: Considering rising health expenditure on the one hand and increasing public expectations on the other hand, there is a need for explicit health care rationing to secure public acceptance of coverage decisions of health interventions. The National Health Security Office, the institute managing the Universal Coverage Scheme in Thailand, recently called for more rational, transparent, and fair decisions on the public reimbursement of health interventions. This article describes the application of multicriteria decision analysis (MCDA) to guide the coverage decisions on including health interventions in the Universal Coverage Scheme health benefit package in the period 2009‐2010. Methods: We described the MCDA priority-setting process through participatory observation and evaluated the rational, transparency, and fairness of the priority-setting process against the accountability for reasonableness framework. Results: The MCDA was applied in four steps: 1) 17 interventions were nominated for assessment; 2) nine interventions were selected for further quantitative assessment on the basis of the following criteria: size of population affected by disease, severity of disease, effectiveness of health intervention, variation in practice, economic impact on household expenditure, and equity and social implications; 3) these interventions were then assessed in terms of cost-effectiveness and budget impact; and 4) decision makers qualitatively appraised, deliberated, and reached consensus on which interventions should be adopted in the package. Conclusion: This project was carried out in a real-world context and has considerably contributed to the rational, transparent, and fair priority-setting process through the application of MCDA. Although the present project has applied MCDA in the Thai context, MCDA is adaptable to other settings.
  • References (32)
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References32
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#1Sirinart Tongsiri (MSU: Mahasarakham University)H-Index: 3
#2John Cairns (Lond: University of London)H-Index: 60
Abstract Objective To derive EuroQol five-dimensional (EQ-5D) health states values from the Thai general population. Methods Forty-eight trained individuals successfully conducted interviews with a representative sample of 1409 respondents in 2007. A total of 12 sets of health states were used with one set allocated to each respondent. A respondent was requested to assign values for 11 states using the ranking and visual analogue scale methods and 10 states using the time trade-off method. The v...
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#1Sitaporn Youngkong (Radboud University Nijmegen Medical Centre)H-Index: 6
#2Noor Tromp (Radboud University Nijmegen Medical Centre)H-Index: 10
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Correction After the publication of this article [1], we became aware that two last sentences in the paragraph relied on original ideas following personal communication with a researcher, and should not have been presented here. Consequently, the reference number 9 which was cited for the removed issue should be taken from the article. The correct paragraph is provided below: The explicit weighing of criteria analyzed from DCE may improve the consistency of priority setting across contexts and o...
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#1N. DevlinH-Index: 1
#2J. SussexH-Index: 1
What a health care system should pay for depends, of course, on the health gain that results. Health technology assessment (HTA) and cost-effectiveness analysis have become the core for many such decisions, by NICE in the UK and by similar bodies elsewhere. Other factors, however, also are taken into account by the governments and insurers who fund health care. These typically include - the impact of decisions on social equity[]; the quality of the patient experience; ramifications for the wider...
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#1Yot Teerawattananon (Health Intervention and Technology Assessment Program)H-Index: 31
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