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Investigative issues associated with the chosen health care practices |
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| Health Care Technology/Practice |
Setting |
Interest from methodological and policy perspectives* |
Key Issues |
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| ART ≥ 42 years of age |
Clinic or Hospital |
Harmful x Clinically Effective x Cost Effective ? Appropriate ? Socially Valued √ Universally Accessible ?/x Ethical ? |
- Marginal clinical and cost-effectiveness (on population basis) but limiting its use poses problems: it is highly beneficial from perspective of concerned individuals - Therapy has equivocal purpose - Highly valued by recipients and potentially by society broadly - Ability to pay: user vs society - Equity of access - Medical vs social infertility - Opportunity cost |
| Upper airway surgery for adult OSA |
Surgical Theatre |
Harmful ? Clinically Effective ?/x Effective Alternative √ Cost Effective x Appropriate ? Necessary ? Socially Valued ?/√ Ethical ? |
- Limiting its use should not, in theory, pose any problems, but pressures are strong from clinical interest groups - Complex practice paradigms/incentives - Small, homogeneous craft group - Equipoise/clinical uncertainty - Perspectives of patients who value the potential of a surgical 'fix' - Is this preference based on sound evidence or supplier induced demand? - Opportunity cost |
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*Key: ? = Unsure or in question; x = Limited or evidence in the negative; √ = Evidence in the positive | |||
Elshaug et al. Australia and New Zealand Health Policy 2007 4:23 doi:10.1186/1743-8462-4-23 |
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