Distributional cost effectiveness analysis of West Yorkshire low emission zone policies.
air pollution
decision analysis
economic evaluation
health inequalities
Journal
Health economics
ISSN: 1099-1050
Titre abrégé: Health Econ
Pays: England
ID NLM: 9306780
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
13
03
2019
revised:
20
12
2019
accepted:
29
12
2019
pubmed:
1
2
2020
medline:
19
8
2021
entrez:
1
2
2020
Statut:
ppublish
Résumé
Alternative strategies can reduce road vehicle emissions, with differential effects on exposure across population groups. We compare alternative strategies in West Yorkshire using a framework for economic evaluation that considers multiple perspectives and that takes account of the distribution of health outcomes. Exposure to pollutants by area is converted, via dose response relationships, into disease averted. Health benefits and National Health Service costs from diseases are estimated conditional on population demographics and index of multiple deprivation. The net health benefits from alternative strategies are expressed as distributions of quality-adjusted life expectancy (QALE), which are compared using dominance criteria and societal aversion to health inequality. Net production is estimated from intervention costs and the effects of health improvement on production and consumption. Social care outcomes are estimated from health improvement among care recipients and changes in care expenditure. A switch to less polluting private vehicles is dominant in terms of the distribution of QALE and social care outcomes but not consumption. Inclusion of health inequality aversion alters the rank order compared with prioritisation on health maximisation. The results were sensitive to the magnitude of health opportunity costs, the level of inequality aversion, and the proportion of intervention cost that generates health opportunity cost.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
567-579Subventions
Organisme : Department of Health
ID : PR-110-0001
Pays : United Kingdom
Informations de copyright
© 2020 John Wiley & Sons, Ltd.
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