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dc.contributor.authorHauck, K
dc.contributor.authorMorton, A
dc.contributor.authorChalkidou, K
dc.contributor.authorChi, Y-Ling
dc.contributor.authorCulyer, A
dc.contributor.authorLevin, C
dc.contributor.authorMeacock, R
dc.contributor.authorOver, M
dc.contributor.authorThomas, R
dc.contributor.authorVassall, A
dc.contributor.authorVerguet, S
dc.contributor.authorSmith, PC
dc.date.accessioned2020-09-14T23:22:34Z
dc.date.available2020-09-14T23:22:34Z
dc.date.issued2019
dc.identifier.issn0277-9536en_US
dc.identifier.doi10.1016/j.socscimed.2018.10.030en_US
dc.identifier.urihttp://hdl.handle.net/10072/397485
dc.description.abstractHealth interventions often depend on a complex system of human and capital infrastructure that is shared with other interventions, in the form of service delivery platforms, such as healthcare facilities, hospitals, or community services. Most forms of health system strengthening seek to improve the efficiency or effectiveness of such delivery platforms. This paper presents a typology of ways in which health system strengthening can improve the economic efficiency of health services. Three types of health system strengthening are identified and modelled: (1) investment in the efficiency of an existing shared platform that generates positive benefits across a range of existing interventions; (2) relaxing a capacity constraint of an existing shared platform that inhibits the optimization of existing interventions; (3) providing an entirely new shared platform that supports a number of existing or new interventions. Theoretical models are illustrated with examples, and illustrate the importance of considering the portfolio of interventions using a platform, and not just piecemeal individual analysis of those interventions. They show how it is possible to extend principles of conventional cost-effectiveness analysis to identify an optimal balance between investing in health system strengthening and expenditure on specific interventions. The models developed in this paper provide a conceptual framework for evaluating the cost-effectiveness of investments in strengthening healthcare systems and, more broadly, shed light on the role that platforms play in promoting the cost-effectiveness of different interventions.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.language.isoeng
dc.publisherPergamon-Elsevier Science Ltden_US
dc.relation.ispartofpagefrom141en_US
dc.relation.ispartofpageto149en_US
dc.relation.ispartofjournalSocial Science & Medicineen_US
dc.relation.ispartofvolume220en_US
dc.subject.fieldofresearchMedical and Health Sciencesen_US
dc.subject.fieldofresearchEconomicsen_US
dc.subject.fieldofresearchStudies in Human Societyen_US
dc.subject.fieldofresearchcode11en_US
dc.subject.fieldofresearchcode14en_US
dc.subject.fieldofresearchcode16en_US
dc.subject.keywordsScience & Technologyen_US
dc.subject.keywordsSocial Sciencesen_US
dc.subject.keywordsLife Sciences & Biomedicineen_US
dc.subject.keywordsPublic, Environmental & Occupational Healthen_US
dc.subject.keywordsSocial Sciences, Biomedicalen_US
dc.titleHow can we evaluate the cost-effectiveness of health system strengthening? A typology and illustrationsen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationHauck, K; Morton, A; Chalkidou, K; Chi, Y-L; Culyer, A; Levin, C; Meacock, R; Over, M; Thomas, R; Vassall, A; Verguet, S; Smith, PC, How can we evaluate the cost-effectiveness of health system strengthening? A typology and illustrations, Social Science & Medicine, 2019, 220, pp. 141-149en_US
dcterms.dateAccepted2018-10-31
dcterms.licensehttps://creativecommons.org/licenses/by/4.0/en_US
dc.date.updated2020-09-14T23:18:24Z
dc.description.versionVersion of Record (VoR)en_US
gro.rights.copyright© 2019 The Authors. This is an open access article distributed under the terms of the Creative Commons CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
gro.hasfulltextFull Text
gro.griffith.authorChalkidou, Kalipso


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