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Psycho- Oncology Journal (Jurnal Volume 28 no 1 2019)

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A substantial proportion of cancer patients experience heightened psychological distress that may include anxiety, depression, fear of cancer recurrence, and cancer‐specific distress.1, 2 Improving psychological outcomes of cancer patients across the continuum of care (ie, from diagnosis to survivorship) is a key aspect of oncology care, and as such there is an increasing expectation and requirement that cancer care service providers assess and address patients' psychosocial needs.3 These services vary in complexity depending on the level of psychosocial support required, care setting, and resource availability.4 There is a large body of evidence demonstrating the effectiveness of psychosocial care interventions in reducing depression and anxiety and improving quality of life of cancer patients.5-7 Nevertheless, and due to increasing health care costs, decision makers require evidence on the cost‐effectiveness (ie, value for money) of new services before they can make decisions to fund and implement them in practice. Economic evaluations are increasingly performed to generate evidence about the value for money of new health care interventions.

Economic evaluation involves the comparative analysis of the costs and consequences of alternative options.8 There are four types of economic evaluations: cost‐minimization analysis, cost‐effectiveness analysis, cost‐utility analysis, and cost‐benefit analysis.8 Cost‐minimization analysis assumes that the evaluated interventions have equivalent outcomes but different costs, and accordingly, the decision can be made on the basis of the difference in total cost alone. In cost‐effectiveness analysis, however, the incremental costs are compared with the incremental outcomes, as measured in natural units (eg, life‐years gained, unit improvement in Symptom Distress Scale). A disadvantage of cost‐effectiveness analysis is that it does not enable direct comparison of interventions treating different conditions with different outcomes. In cost‐utility analysis, outcomes are expressed as quality‐adjusted life‐years (QALYs) gained. The QALY adjusts the length of time gained through an intervention by the quality of life associated with health status.8 Given that cost‐utility analysis uses a generic outcome measure (ie, QALY), it allows decision makers to compare different interventions for different conditions. In cost‐effectiveness and cost‐utility analyses, the incremental benefits and costs are generally expressed as the incremental cost‐effectiveness ratio (ICER) which is the difference in cost divided by the difference in health effect between the evaluated interventions. The ICER must be compared with the decision maker's willingness‐to‐pay threshold which, in a limited budget health care system, represents the opportunity cost of health benefits forgone elsewhere from the investment in the new intervention.8 An alternative approach to using an ICER is to estimate the incremental net monetary benefit, which is the increase in effect multiplied by the willingness‐to‐pay‐threshold, less the increase in cost. The new intervention is considered cost‐effective if the incremental net benefit is positive. An analysis that measures both the costs and outcomes in monetary units is called cost‐benefit analysis.

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

JUR.POJ.28.1.19

Penerbit

: wiley., 2019

Deskripsi Fisik

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Bahasa

English

ISBN/ISSN

1057-9249

Klasifikasi

JUR.POJ.28.1.19

Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

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Subjek

Jurnal Kesehatan
Jurnal Internasional

Info Detail Spesifik

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Pernyataan Tanggungjawab

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Versi lain/terkait

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