The validity of the MIMIC health index — some empirical evidence

Abstract

The rise of medical care expenditure over the last few decades has made the economic evaluation of medical services increasingly important. However, economic appraisal of specific medical therapies is a complex issue, particularly with respect to the benefit side of the analysis. Previous studies often have ignored treatment benefits, restricting analysis to cost differentials between treatment alternatives or have focused exclusively on improvements in patients’ earnings capacity through reductions of morbidity or mortality. Both approaches are clearly unsatisfactory if (i) a new therapy constitutes significant therapeutic progress without reducing treatment costs, (ii) the major effect of a new therapy is to improve patients’ well-being, enjoyment of life, or life quality rather than to increase longevity or earnings capacity and (iii) the benefits of a new therapy accrue mainly to patients who are not part of the labor force, i.e. persons working in the household or retired people. In all these situations, economic evaluation requires assessment of the direct and immediate treatment benefits: the improvement in patients’ well-being (life quality).

The research presented here was in the first phase financed by Thomae AG, Biberach, in the second by the Swiss National Science Foundation (Project No. 3.927-0.85). It draws on earlier work of other people who have been engaged in this project at some point: dipl. psych. Rosemarie Deutschmann (Deutschmann & Co., Basel) designed the patient questionnaire and did the interviews, Dr. Thomas Keller provided the two physician scales used in Section 7. The authors would like to thank Peter Zweifel for helpful comments.