2.3 Evaluating healthcare delivery models
Evaluating healthcare delivery models involves assessing various aspects of their performance, effectiveness, impact on patient outcomes, cost and patient satisfaction. Clinical outcome measures such as health services use, mortality rates, morbidity, complication rates and disease progression are important, in addition to patient-reported outcomes such as quality of life, functional status and satisfaction with care provided (Hollingsworth, 2016).
Cost–benefit assessment
Cost–benefit assessment can be done using various metrics, such as diagnosed or prevented conditions, life years gained or quality-adjusted life years (QALYs). QALYs are particularly significant as they consider both the length and quality of life. They are useful in comparing the benefits of different interventions, from cancer treatment to preventive measures like HIV screening, in a standardised manner (Thomas & Chalkidou, 2016).
Cost-effectiveness ratios
Cost-effectiveness ratios, expressed as dollars per health outcome, are commonly used in evaluating interventions. For instance, the cost-effectiveness of HIV screening might be expressed as $15,000 per QALY gained. However, assessing cost-effectiveness faces challenges such as varying evidence quality, obtaining accurate cost data and understanding how health outcomes impact patients’ quality of life. Despite these challenges, careful analysis provides valuable insights into intervention effectiveness and cost-effectiveness (Thomas & Chalkidou, 2016).
Process evaluation
Process evaluation is also important to determine the most efficient way to implement a new system. Process evaluation could include assessing the model used, waiting times, appointment scheduling, coordination of care and adherence to treatment guidelines. It could also cover access and equity issues, such as geographical accessibility, affordability, equity across different population groups, socio-economic status and demographic characteristics (May et al., 2007).
By using a combination of evaluation methods and considering various stakeholders’ perspectives, healthcare organisations and policymakers can make informed decisions about the adoption, adaptation or discontinuation of specific healthcare delivery models. Additionally, ongoing evaluation is essential to identify opportunities for improvement and ensure the delivery model’s continued effectiveness and relevance.
