Distributional cost-effectiveness analysis
Distributional cost-effectiveness analysis (DCEA) is a general umbrella term for economic evaluation studies that provide information about equity in the distribution of costs and effects as well as efficiency in terms of aggregate costs and effects.
DCEA can provide distributional breakdowns of who gains most and who bears the largest burdens (opportunity costs) by equity-relevant social variables (e.g. socioeconomic status, ethnicity, location) and disease categories (e.g. severity of illness, rarity, disability). DCEA can also use various forms of "equity weighting" to analyse trade-offs between equity and efficiency. This page includes various DCEA publications and training resources that CHE staff have developed or been involved in developing.
Journal articles:
- Using cost-effectiveness analysis to address health equity concerns. Value in Health 2017
- Distributional cost-effectiveness analysis of health care programmes – a methodological case study of the UK bowel cancer screening programme. Health Economics 2014
- Distributional Cost-Effectiveness Analysis: A Tutorial. Medical Decision Making 2015
- The Social Distribution of Health: Estimating Quality-Adjusted Life Expectancy in England. Value in Health 2015
- Equity-informative health technology assessment – a commentary. Social Science & Medicine 2016. Accepted manuscript version Cookson - commentary on equity-informative economic evaluation (PDF
, 294kb)
Report:
- Identifying appropriate methods to incorporate concerns about health inequalities into economic evaluations of health care programmes. Final Report 2014.
Blog:
- Method of the month: Distributional cost effectiveness analysis - Miqdad Asaria
Book chapters:
- Incorporating health inequality impacts into cost-effectiveness analysis (PDF , 330kb), in the Elsevier On-line Encyclopedia of Health Economics, 2014
- Measuring health inequality in the context of cost-effectiveness analysis (PDF , 700kb), in Health and Inequality (Research on Economic Inequality, Volume 21), 2013
Working papers:
- Fairer decisions, better health for all: Health equity and cost-effectiveness analysis CHE Research Paper 135 (PDF , 1,713kb)
- Years of good life based on income and health: Re-engineering cost-benefit analysis to examine policy impacts on wellbeing and distributive justice CHE Research Paper 132 (PDF , 2,282kb)
- Eliciting the level of health inequality aversion in England CHE Research Paper 125 (PDF , 2,174kb)
Training:
Handbook
- Oxford University Press handbook of distributional cost-effectiveness analysis
- Online spreadsheet training exercises in distributional cost-effectiveness analysis, accompanying the Oxford University Press handbook
- Online distributional cost-effectiveness analysis tool
Professional networks
Webinar
For the public
- Learning about economic evaluation and health inequality (PDF , 1,060kb)
- Conducting DCEA using aggregate data (PDF , 279kb)
Msc workshop
These presentation materials are copyright University of York and may not be reproduced without prior permission. However, we are happy for you to re-use them for non-commercial educational or research purposes so long as you acknowledge the authors and let us know.
Old MSc Workshop Feb 2018
- MSc Equity Workshop - Instructions (MS Word
, 28kb) - MSc Equity Workshop - Student File (MS Excel
, 143kb) - MSc Equity Workshop - Solution File (MS Excel , 146kb)
- Equity workshop at Society for Social Medicine Sep 2016 (PDF , 1,363kb)
- Cookson on DCEA (PDF , 1,089kb)
Policy workshop materials:
- Workshop 1 in March 2012 (overview)
- Workshop 2 in February 2013 (bowel cancer screening case study)
Funding:
- DH Policy Research Programme Public Health Research Consortium (PHRC), 2011-19
- NIHR Senior Research Fellowship 2014-18