Priority Shifting and the Dynamics of Managing Eradicable Infectious Diseases

• 成果类型: Article
• 署名作者: Tebbens, Radboud J. Duintjer; Thompson, Kimberly M.
• 署名单位: Harvard University; Harvard T.H. Chan School of Public Health; Delft University of Technology
• 刊物名称: MANAGEMENT SCIENCE
• ISSN/ISSBN: 0025-1909
• DOI: 10.1287/mnsc.1080.0965
• 发表日期: 2009
• 页码: 650-663
• 关键词: infectious diseases; disease eradication; Health economics; Stochastic Model; system dynamics; perception delay; benefit-cost analysis

摘要

Public health budget constraints force policy makers to prioritize resources toward those interventions that yield the highest perceived benefits. Intuitively, it appears optimal to focus resources on affordable interventions against prevalent diseases. However, due to the dynamics of infectious disease eradication, policies focusing on a static perception of priorities may lead to economically suboptimal outcomes. Using a hypothetical two-disease dynamic transmission model, we explore several different decision rules with respect to vaccination policy for eradicable diseases. The simulations show that cost-effectiveness decreases as the extent of priority shifting increases. This model suggests the need for a longer-term dynamic perspective to appropriately recognize costs and benefits of different policies for eradicable diseases.