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In this paper, we critically review cost‐benefit analysis, cost‐effectiveness analysis and the guard‐rail approach as decision‐support tools for the choice of climate protection strategies. Our main focus is on the central role of value judgments, which arise from the need to value; first, uncertain environmental benefits from climate protection relative to other goods; second, the consumption of the present relative to future generations; and third the consumption of “poor” relative to “rich” people. Each of the three approaches analyzed has its shortcomings. Cost‐benefit analysis requires a complete and transitive preference ordering, which stands in sharp contrast to scientific uncertainties and valuation problems. Cost‐effectiveness analysis suffers from the difficulty of setting an appropriate climate protection target. Finally, the usefulness of the guard‐rail approach for decision‐makers depends on the extent to which it is possible to limit the choice set.

The purpose of this paper is to propose a microeconomic-based approach to support fund-allocation decisions for a large number of assets. Under the prevailing financial constraints and rapid deterioration of facilities, arriving at optimum fund allocation for capital renewal projects has become very challenging. Due to the complexity of modeling multi-year life cycle cost analysis, existing fund-allocation methods have serious drawbacks when handling a large portfolio of assets, and their results are difficult to justify.

This paper adopts well-established theories from microeconomics and proposes a new microeconomic-based decision support framework that has two novel components: a heuristic procedure to optimize and justify fund-allocation decisions by balancing the funding among the different asset categories; and a visual what-if analysis approach inspired by the economic indifference maps.

Applying the proposed framework on a real case study of 800 building components proved that optimum decisions can be achieved through an equilibrium state at which fair and equitable allocations are made such that the utility per dollar is balanced for all asset categories. The visual what-if analysis approach presented a powerful graphical tool to visualize decisions, along with their costs and benefits, and facilitate sensitivity analysis under changes in budget levels.

This paper, using the proposed microeconomic framework, sheds a new light on how fund-allocation optimization problems can be simplified, from an economic perspective, to arrive at accurate and justifiable decisions for a large portfolio of facilities.

Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective.

This research employs randomized, prospective studies to obtain robust cost and utility data used in the Markov chain decision model for examining which of these surgical interventions is more effective in treating women with stress UI based on two measures: number of quality adjusted life years (QALY) and cost per QALY. Treeage Pro Healthcare software was employed in Markov decision analysis.

Results showed the Sling procedure is a more effective surgical intervention than the Burch. However, if a utility greater than certain utility value, for which both procedures are equally effective, is assigned to persistent incontinence, the Burch procedure is more effective than the Sling procedure.

This paper demonstrates the efficacy of a Markov chain decision modeling approach to study the comparative effectiveness analysis of available treatments for patients with UI, an important public health issue, widely prevalent among elderly women in developed and developing countries. This research also improves upon other analyses using a Markov chain decision modeling process to analyze various strategies for treating UI.

Substantial investments are now being made in quality assurance programmes throughout the developed world. Proposes that economic evaluation is one approach to justifying these in terms of value for money. Three key elements are: comparison with some alternative course of action; measurement of costs; and measurement of consequences. Illustrates the difficulties of addressing these by a case‐study – an audit programme aiming to increase the use of intravenous thrombolysis for acute myocardial infarction. Discusses the production of accurate costings; the wide confidence limits associated with regression analysis; and the numerous assumptions required in the modelling of effectiveness. Economic evaluation of quality assurance programmes may be useful in future, if the required data can be collected.

A rich literature has documented gender-based differences in health care utilization and outcomes. The role of risk attitude in explaining the variations is limited at best. This study examines gender differences in health utilities and risk attitudes.

Data on 13 health states were collected from 629 students via questionnaires at the Ben-Gurion University of the Negev in 2005. From each respondent, we assessed utilities for a subset of health states, using Time Trade-Off and Standard Gamble. A risk attitude coefficient was calculated for each respondent as a function of their utilities for all outcomes assessed. The risk coefficient derived from a closed-form utility model for men was compared to that of women using the t-statistic.

There was a statistically significant difference in the risk attitudes of men and women. Men had a concave utility function, representing risk aversion, while women had a near linear utility function, suggesting that women are risk neutral.

Differences in risk attitude may be an important contributor to gender-based disparities in health services utilization. More research is needed to assess its full impact on decision-making in health care.

The purpose of this paper is to identify the existing literature on the wide range of operations research (OR) studies applied to healthcare, and to classify studies based on application type and on the OR technique employed. The scope of the review is limited to studies which have been undertaken in the UK, and to papers published since the year 2000.

In total, 142 high‐quality journal and conference papers have been identified from ISI Web of Knowledge data base for review and analysis.

The findings categorise the OR techniques employed, and analyse the application type, publication trends, funding, and software packages used in the twenty‐first century in UK healthcare. Publication trends indicate an increasing use of OR techniques in UK healthcare. The findings show that, interestingly, the distribution of the OR techniques employed is not uniform; the majority of studies focus on simulation, either as the only technique employed or as one element of a multi‐method approach.

Several studies have focused on the use of simulation in healthcare modelling, but none has methodologically reviewed the use of the full range of OR techniques. This research is likely to benefit healthcare decision makers since it will provide them with an overview of the different studies that have utilised multiple OR techniques for investigating problems in the stated domain.

Health economics is now a well‐established topic within the discipline of economics. A 5,500‐item bibliography covering material up to 1982 is available (Blades et al, 1986). Health economists write on such diverse matters as (to select at random) demand for acute care in hospitals, the costs of illness, the economics of alcoholism, cost‐benefit analysis in magnetic resonance imaging, and the pros and cons of any number of ways of financing the delivery of health services. Here in the UK the Health Economists' Study Group boasts around 150 members. Meanwhile, hardly a day goes by without the newspapers containing items concerning topics which could form the basis for health economists' involvement in analysis, evaluation and, in some cases, policy advice. The jargon of economics and evaluation is becoming familiar to a wider audience: thus articles on cost‐effectiveness and cost‐benefit analysis appear regularly in medical journals and the quality‐adjusted life‐year (QALY) has featured on TV. Thus a review of some of the recently published books in this area would appear appropriate at this juncture.

This innovative analysis aims to quantify the use of evaluation criteria in telemedicine and to identify current trends in metric adoption. The focus is to determine the frequency of actual performance metric reporting in telemedicine evaluation, in contrast to systematic reviews where assessment of study quality is the goal.

Automated literature search identified telemedicine studies reporting quantitative performance metrics. Studies were classified by telemedicine class; store‐and‐forward (SAF), real‐time consultation (RTC) and telecare (TC), and study stage. Studies were scanned for evaluation metric reporting, i.e. clinical outcomes, satisfaction, patient quality and cost measures.

Evaluation metric use was compared among telemedicine classes, and between pilot and routine use stages. Diagnostic accuracy was reported significantly more frequently in pilots for RTC and TC. Cost measures were more frequently reported in routine use for TC. Clinical effectiveness and hospital attendance were better reported in routine use for SAF. Comparison also revealed different evaluation strategies. In pilots, SAF favoured diagnostic accuracy, compared to RTC and TC. TC preferred clinical effectiveness evaluations and TC more frequently assessed patient satisfaction. Cost was only reported in less than 20 per cent of studies, but most frequently in RTC. Routine use led to increased reporting of all metrics, except diagnostic accuracy. Clinical effectiveness reporting increased significantly with routine use for RTC and SAF, but declined for TC.

Clinical outcomes and patient satisfaction were reported frequently in telemedicine studies, but reporting of other performance metrics was rare. Understanding current trends in metric reporting will facilitate better design of future telemedicine evaluations.

Business case (BC) analyses are performed in many different business fields, to create a report on the feasibility and competitive advantage of an intervention within an existing organisation to secure commitment from management to invest. However, most BC research papers on decisions regarding internal funding are either based on anecdotal insights, on analyses of standards from practice, or focused on very specific BC calculations for a certain project, investment or field. A clear BC process method is missing.

This paper aims to describe the results of a systematic literature review of 52 BC papers that report on further conceptualisation of what a BC process should behold.

Synthesis of the findings has led to a BC definition and composition of a 20 step BC process method. In addition, 29 relevant theories are identified to tackle the main challenges of BC analyses in future studies to make them more effective. This supports further theoretical development of academic BC research and provides a tool for BC processes in practice.

Although there is substantial scientific research on BCs, there was not much theoretical development nor a general stepwise method to perform the most optimal BC analysis.

This study aims to determine elements of telehealth that have the potential to increase costs for the health system in the short to medium term.

A search of PubMed, EMBASE and Scopus databases was performed in May 2018 using broad terms for telehealth and economics. Articles were included if they identified and explained reasons for an increase in cost for telehealth services. Studies were categorised by economic analysis type for data extraction and descriptive synthesis.

Fourteen studies met inclusion criteria and were included in the review. These studies identified that increased health system costs were due to implementation costs (e.g. for equipment, software or staff training), increased use of other healthcare services (e.g. pharmaceutical services) and ongoing service costs (including staff salaries) resulting from telehealth being additive to traditional service (e.g. increased frequency of contact).

Telehealth is often assumed to be a cost-effective method of delivering healthcare, even to the point where direct cost savings are expected by decision makers as a result of implementation. However, this investigation suggests it does not routinely reduce costs for the health system and can actually increase costs at both implementation and ongoing service delivery stages. Health services considering implementing telehealth should be motivated by benefits other than cost reduction such as improved accessibility, greater patient centricity and societal cost–benefit.