Outcome valuation and economic evaluation in maternal and reproductive health care can be complicated by the fact that: 1. Alternative interventions can be geared towards enhancing the experience of women undergoing care, rather than improving health status; and 2. Alternative interventions can directly affect the health and wellbeing of both woman and infant(s) This thesis explores methods for overcoming these challenges. A review of the literature indicates that: 1) while stated preference techniques have been used to value patient experience in the context of reproductive health care, few studies have incorporated such values into full economic evaluations; 2) while health state valuation techniques have been adapted to value combined mother-infant health outcomes, these techniques have never been used to value outcomes of alternative approaches to assisted reproduction; and 3) no economic evaluations in this area have explicitly considered preferences for the distribution of benefits between women and newborn infants. These gaps are addressed though three empirical case studies. The first demonstrates a method for measuring and incorporating women’s preferences for patient experience factors into an economic evaluation comparing alternative approaches to labour management. The second assesses women’s preferences for mother-infant health outcomes in the context of an economic evaluation comparing alternative approaches to IVF treatment. The final case study adopts an approach to estimate the relative monetary value that community members place on the prevention of maternal and neonatal deaths, in the context of decisions between competing health care programmes that impact differentially on these outcomes. The case studies show that the challenges identified above can be overcome by adapting one or other of the stated preference valuation techniques available to health economists. DCEs in particular offer a flexible approach to dealing with the complexities and trade-offs that can arise when considering choices between alternative reproductive health care interventions in the context of scarce resources.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:558598 |
| Date | January 2011 |
| Creators | Scotland, Graham |
| Publisher | University of Aberdeen |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=186218 |
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