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      Systematic review of economic evaluations and cost analyses of guideline implementation strategies

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      Vale 2007.pdf (438.0Kb)
      Publication date
      2007
      Author
      Vale, Luke David
      Thomas, Ruth Elizabeth
      MacLennan, Graeme Stewart
      Grimshaw, Jeremy
      Metadata
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      Abstract
      Objectives To appraise the quality of economic studies undertaken as part of evaluations of guideline implementation strategies; determine their resources use; and recommend methods to improve future studies. Methods Systematic review of economic studies undertaken alongside robust study designs of clinical guideline implementation strategies published (1966-1998). Studies assessed against the BMJ economic evaluations guidelines for each stage of the guideline process (guideline development, implementation and treatment). Results 235 studies were identified, 63 reported some information on cost. Only 3 studies provided evidence that their guideline was effective and efficient. 38 reported the treatment costs only, 12 implementation and treatment costs, 11 implementation costs alone, and two guideline development, implementation and treatment costs. No study gave reasonably complete information on costs. Conclusions Very few satisfactory economic evaluations of guideline implementation strategies have been performed. Current evaluations have numerous methodological defects and rarely consider all relevant costs and benefits. Future evaluations should focus on evaluating the implementation of evidence based guidelines. Keywords: Cost-effectiveness analysis, physician (or health care professional) behaviour, practice guidelines, quality improvement, systematic review.
      Citation
      Vale, L., Thomas, R., MacLennan, G., and Grimshaw, J. (2007) Systematic review of economic evaluations and cost analyses of guideline implementation strategies. European Journal of Health Economics, 8, pp.111-121.
      URI
      http://hdl.handle.net/2164/152
      DOI
      http://dx.doi.org/10.1007/s10198-007-0043-8
      Rights
      The original publication is available at www.springerlink.com
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