Quasi-experimental methods in evaluating effectiveness in health care and health economics.
DOI:
https://doi.org/10.23990/sa.122529Keywords:
Causal inference, quasi-experimental design, natural experiment, health economics, effectivenessAbstract
One of the most central concepts in health economics is effectiveness. The term ‘effect’ usually refers to how the outcome of interest in the treatment group under study develop after the intervention compared to the situation where the intervention would not have been carried out. In medicine, effectiveness is mostly studied using randomized trials. The role of randomized experiments has traditionally been less important in the social sciences, although large-scale social experiments have been carried out at least since the 1970s.
The added value of health economics as a tool for organizing healthcare operations has primarily been seen in the prioritization and systematic review of alternative uses of resources, not so much in the area of impact evaluation. However, the methodological advances in economics and their applications in health economics in recent decades have illustrated the important role of credible research designs in the evaluation of effectiveness. For many important questions in health economics, the most viable option for effectiveness evaluation is to use observational quasi-experimental designs and related econometric methods instead of rando-mized experiments. A significant advantage of quasi-experimental methods is their applicability to many important issues related to health policy and healthcare services, and also, the fact that the methods enable credible effectiveness and cost-effectiveness evaluations to be made in a manner similar to randomized trial designs.
This article presents experimental and quasi-experimental methods used in modern health economics literature as well as some recent health economic applications based on quasi-experimental methods. In addition, the article evaluates the impact of the so-called credibility revolution on health economics research. Another aim of this paper is to illustrate for students and researchers the possibilities of utilizing quasi-experimental designs in topical questions dealing with social and health care.
