An equity–effectiveness framework linking health programs and healthy life expectancy
David Banham A C , John Lynch B and Jon Karnon B
+ Author Affiliations
- Author Affiliations
A Research and Ethics Policy Unit, SA Health, 11 Hindmarsh Square, Adelaide, SA 5000, Australia.
B Department of Public Health, School of Population Health and Clinical Practice, Level 7, 178 North Terrace, University of Adelaide, Adelaide, SA 5005, Australia.
C Corresponding author. Email: david.banham@health.sa.gov.au
Australian Journal of Primary Health 17(4) 309-319 https://doi.org/10.1071/PY11034
Submitted: 29 March 2011 Accepted: 1 September 2011 Published: 15 November 2011
Abstract
South Australia’s Strategic Plan includes a target to improve the population’s healthy life expectancy. A common question among health policy and service planners is: ‘How do health programs and services in the community relate to healthy life expectancy?’ In response, this paper outlines an effectiveness and equity framework (EEF) for evaluating health interventions in applied settings. Using the example of coronary heart disease (CHD) management in general practice in South Australia, the EEF: (1) applies an internally consistent approach to accounting for population healthy life expectancy at state and smaller geographic levels; (2) estimates average population health gains from health programs, and gains across different socioeconomic subgroups within the community; (3) conducts economic evaluation by equating health gains against health system costs in population subgroups; (4) summarises relevant information about candidate intervention programs within a multi-criteria performance matrix for presentation to decision makers; (5) reassesses outcomes (and processes) following the implementation of a program and iteratively adds to the relevant knowledge and evidence base. The EEF offers a practical approach to selecting and evaluating intervention programs. The challenge is to develop system culture and data capture methods clearly focussed on linking health system activities to population health outcomes.
Additional keywords: cost effectiveness, DALY, health equity, health care, health inequalities, patient-reported outcome measures, quality indicators.
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