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Speaker:Chair Professor Jung-Der Wang (Department of Public Health College of Medicine, NCKU)

Seminar
Poster:Webmasters事件日期:2018-10-05
 
Topic:Health technology assessment in the era of pay-for-value and big data
 
Speaker:Chair Professor Jung-Der Wang
(Department of Public Health College of Medicine, NCKU)
 
Date Time:FRI. Oct 5,2018, 10:40 AM - 11:30 AM 
 
Place: 4F-427, Assembly Building I

Abstract

Although the use of National Health Insurance Research Database has already produced thousands of articles published on journals listed on SCI/SSCI, there are concerns about whether valuable scientific knowledge were produced. In fact, big data by themselves cannot generate any new knowledge. Based on domain knowledge, investigators can propose and test hypotheses, which may modify clinical guidelines, improve the cost-effectiveness and sustainability for the universal coverage system of our National Health Insurance. Nowadays the conventional paradigm of pay-by-volume has been shifting toward pay-by-value. The value must be considered from patients' and society's viewpoints, of which health benefits per dollar spent would be of major concerns and lifetime survival, quality of life, functional disability, costs, and cost-per-QALY (quality-adjusted life year) are basic measurements. To tackle the above challenges, my team have developed methods for extrapolation of survival function to lifetime, adopting kernel smoothing means for cross-sectional collection of data, and simulating age- and sex-matched referents from our national life tables for calculation of the health benefits from prevention. The methods can quantify life expectancy (LE), loss-of-LE, quality-adjusted life expectancy (QALE), loss-of-QALE, duration of long term care need, and lifetime healthcare expenditures for major illnesses after linkages of different big databases. We have compared cost-per-QALY for peritoneal dialysis & hemodialysis, prolonged mechanical ventilation, and cancer care of different organ-systems as examples. By integrating these outcome measurements with incidence rates of different risk factors, we are able to directly compare preventive medicine with clinical, rehabilitative, and alternative medicines along the same metrics, which would facilitate both national and clinical health policy decisions. 
 
Last modification time:2018-10-05 PM 12:03

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