I am not sure that this story connects the tunneladoras how milling Carles Illa narrated at his entrance to Porter and the maze of valueBut I hope to contribute some light to the collective torment that seems that we share the Hueno de Carles, a server, and regular suspects of this #Delvalor.
The point is that I was also molying this apparent happy idea of Porter and commented a while ago at the entrance: Porter’s theory lacks street. Result that: the value is defined as the relationship of the Patient -centered results (PCO, in English) and the costs incurred in it to reach them. But, beyond some tools so that you do not go crazy, I decided -the pco you have to consider, it does not tell you how it estimates the value in a more or less way -systematic and funds and Fidel must leave the equation. Come on, with all your GEPETOIt offers you a manida equation for health economists, and for many of health who are not economists.
Porter tells you that, he hears, that we have to give more light to the focus that illuminates the person patients –minipunto para-é-; But it does not tell you or how you should estimate the value or give you a proof that this can be done by providing any decision rule that I spend on this Without lively. I don’t know if calling it Magic goalkeeper EITHER PORTECRISTOBecause, as Carles says: Porter is a hornyAnd I believe that we, his faithful horny.
At the entrance Porter’s theory lacks streetin addition to Put a broth A goalkeeper, in the background it was intended to show a sensible way -with his limitations, hey! – On how to gather all those PCO and get a numerator of the value of value. Well, once the editor told us that he not only seemed sensible, but worthy of being publishedWe wanted the equation: how is that pod interpreted, then? Will it serve something? Thus, we plug the estimates of the numerator and denomator for two centers.
HCTO: Center a; HCB: Center B. Average values of the numerator and the denominator for center center. The numerators go from 0 to 100 and the denominators, as we know, have no roof. The numerator is measured as, a patient -centered result, the year of adjusted (racial) life, below I explain.
When Carles reads this, he kills me. Neither Avac nor Pco: The Pacely are here.
Roughlyand for whom Not at the parrotan avac (years of life adjusted by quality) measures a Result informed by the patient Generic, using for example the EQ-5D instrument, which serves a priori for any diagnosis, and combines it together with the survival of the patient. In other words, how much life we have left and with what quality we will enjoy it. Below, a helpful illustration where we have those that mass that an avac is nothing more than the area below the curve: the integral that struggled to those who were in letters in the institute.
The idea is as follows: if in the previous entry we were able to put the PCOs together and cek a compound indicator between 0 and 100, what bad would we be doing to anyone to redear the survival and find an avac To the goalkeeper?
Now he had to go to the baptismal battery, and this is already known: we wanted to put pala for what patient, balanced AND lifeBut he was already coined, so we put Palely. Something like Avac that emanates from species questionnaires instead of a generic one, and that is measured between 0 and 100 instead of 0 and 1. we think that, as the first accusation to measure the numerator, it could not serve.
A glass is a glass, and a dish is a dishM.roy dixit. But Undungely is not an avac, it is only liked.
You returned to the previous example, the fine line of what provides greater or lesser value. Without pulling the pool, we could, to say that the center A seems like a health care of mayor value in 0.0003 Value units? It seems an extra reason, perhaps that Goyesca reason that produces monsters and that the dream occupies me.
The dream of reason produces monsters. Series The whims. Francisco de Goya, Madrid, toward 1799.
Congo this adgroles, we decided to draw these resulting to see what it looks like: a pair of numbers in a cost diagram and straight the line with the lowest brave slope of those peers to the origins would be the rich representative to the central without more: less pending, mayor value. However, a regret of seeing him painted, as of those of the 0.0003 without seduced, a strange reason that I do not know, if he produced monsters or rather serious doubts on his interpretation and informative value. You had to turn around this.
A value plane, or as it is said
HC: Medical Care Center. Health center or provisor, in English; Pacely: Patient -centered result The year of life
This Carles probably does not know, but two blades collided the lava in the reconstruction after the eruption of the volcano TajogaitaIn La Palma. I think it is a light of hope so that one day the tunneladoras of Carles touch that mountain of value.
The imagery of the roundabout at the crossroads of the Cruz Chica sent by the president of the Mr. Cabildo of the palm of the time.
Now I bring what a server commented year ago to place them. Come, I explain to me: If you transform the equation of the value of Naive way In a delta version between individuals or hospitals we would be in a place close to the incremental cost-effectiveness relationship (RCEI), only with the numerator and denominator exchanged.
Et voilà… I present them to Inverse incremental value (Innocent). Yes, I didn’t break my head, but you had to be certain.
Nothing beyond a marginal perspective of the value equation Upside cucumberwith the costs of the costs of the results in health below. Nothing more equivalent to RCEI, only that an avac are Pacely, and instead of comparing two technologies, we compare the health care of two centers. Already … that when I go, you are coming, that I know them. They will ask that center is the comparator. Without regard, for now, we assume the center as a comparator and we at once estee that INIV Molon One contributes to see that.
A boat soonIt could be detached that Center B is able to generate an additional plangely for 376 euros. We could agree that, this could be something more informative than the initial comparison, and I could say because I think it believes it provides something else, but it is maturing it. And although he hesitated between the singular and plural voice, the bad, because Arantzazu rooted It has accompanied me in this torment. In addition, on the way you meet good, double good people, with good science and good heart, which makes you a commentator in a VI Management and does not hesitate to offer your healthy and dedicated criticism. Eskerrik Asko, Eduardo Sánchez-Iriso.
Returning to that cost for additional Paley of 400 euros, I know that you come when I go, and that the CUICOS From the place they are thinking that without a value threshold it does not work for much, or rather, not at all. Well, be it to recognize that we will not have a value threshold in a long time because for that you would have to generate critic and systematic mass of little costs; And this is not, nor is it read, because this one of the ASBV does not know if it is a fable or a desiderastum, but along the way I entertain myself.
Before Seual, an incremental value plane and an acceptability curve are painted in terms of value. I am not going to give him more ball than he has. When a more health center a cost mayor, the INIV is in the northeast quadrant of God’s lifetime, and since we have no threshold, then Nanay of China. It goes without saying that if we were in the northwest/southeast quadrant, the thing would be clearer with one of the centers contributing more health and less cost than the Ototro, a bargain to know what the Rast, come on.
An incremental inverse value plane, or as stated.
The black point is the 376 eruly INIV by Pacely. The blue points son simulations with Bootstraping To see how it moves is INIV
An acceptability curve in terms of value, or as it says.
One heights will be thinking that we are the most horny faithful in Porter. Well, I tell you no, that magazine editor, a friend confessed from Porter, and had declared an initial interest in which I am telling you, told us this descender of two months paper Editors
I send something like: Is the market, friend. A while Dixit; EITHER, It’s the market, child. I. Farray Dixit
That may not be irresistibleWe have to make it look at the authors, but without something more of methodology and decision rules, the ASBV could end up if a Toast to the sun. We were not going to change what the readers do because Porter’s equation either used it, Clarinete Clarito. I do not put my answer because if not this would be a Save me scienceBut I want to have the investigation hinge and the decision making It is without greasing in #Lodelvalor. In those we are. End of the Pateta.
I continue with the story of InnocentThis entertaining tells you that, if instead of two centers we had five, we could draw a value border an image and likeness of a health production border. I said Juan Virdis In the XIII higher evaluates than this could be done using data envelope analysis. Myriam Soto That he was in the room, picked up the witness and got into this asBV for calculation the blissful border, that border where the affections occur, he said Island shrimp. What the workshops have evaluated, you go to one and you get friends everywhere. Thanks, Juan and Myriam.
In the XLIV Days AES, Daniel Santín We suggested exploiting individual data and trying a stochastic analysis or a metaphrontera. What the days have, that you find people who know and want to help. Frame coverOr, biosystemk partner, while we turned another return, he suggested to draw a Pareto border. Thanks, Daniel and Marco.
I put under the border of the friend Pareto. It seems that the center g dominates A, B and E, and the center d dominates the by E. well, because with this border -which I am not going to give here the interpretive ball that deserves because we have any cloth to cut -Sol Better performance in value, and that the rest are not doing so well. This enables us not to choose a comparator center to calculate the cost per patient.
A border of value to the Pareto, or as it is said
If we paint the border first and then apply the INIV of the fans centers to their Better performanceWe can start an obtenero an assortment of cost estimates by Pacely that, to me, call me crazy, it seems to me that it offers a land Aboneae to give a turn once and for all to the payment by value and not remain in the payment for results.
If not, let Porter go and see it.
