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Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis

BACKGROUND: Surveillance and intervention are resource-using activities of strategies to mitigate the unwanted effects of disease. Resources are scarce, and allocating them to disease mitigation instead of other uses necessarily involves the loss of alternative sources of benefit to people. For soci...

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Autores principales: Häsler, Barbara, Howe, Keith S, Stärk, Katharina DC
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189394/
https://www.ncbi.nlm.nih.gov/pubmed/21929812
http://dx.doi.org/10.1186/1472-6963-11-225
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author Häsler, Barbara
Howe, Keith S
Stärk, Katharina DC
author_facet Häsler, Barbara
Howe, Keith S
Stärk, Katharina DC
author_sort Häsler, Barbara
collection PubMed
description BACKGROUND: Surveillance and intervention are resource-using activities of strategies to mitigate the unwanted effects of disease. Resources are scarce, and allocating them to disease mitigation instead of other uses necessarily involves the loss of alternative sources of benefit to people. For society to obtain the maximum benefits from using resources, the gains from disease mitigation must be compared to the resource costs, guiding decisions made with the objective of achieving the optimal net outcome. DISCUSSION: Economics provides criteria to guide decisions aimed at optimising the net benefits from the use of scarce resources. Assessing the benefits of disease mitigation is no exception. However, the technical complexity of mitigation means that economic evaluation is not straightforward because of the technical relationship of surveillance to intervention. We argue that analysis of the magnitudes and distribution of benefits and costs for any given strategy, and hence the outcome in net terms, requires that mitigation is considered in three conceptually distinct stages. In Stage I, 'sustainment', the mitigation objective is to sustain a free or acceptable status by preventing an increase of a pathogen or eliminating it when it occurs. The role of surveillance is to document that the pathogen remains below a defined threshold, giving early warning of an increase in incidence or other significant changes in risk, and enabling early response. If a pathogen is not contained, the situation needs to be assessed as Stage II, 'investigation'. Here, surveillance obtains critical epidemiological information to decide on the appropriate intervention strategy to reduce or eradicate a disease in Stage III, 'implementation'. Stage III surveillance informs the choice, timing, and scale of interventions and documents the progress of interventions directed at prevalence reduction in the population. SUMMARY: This article originates from a research project to develop a conceptual framework and practical tool for the economic evaluation of surveillance. Exploring the technical relationship between mitigation as a source of economic value and surveillance and intervention as sources of economic cost is crucial. A framework linking the key technical relationships is proposed. Three conceptually distinct stages of mitigation are identified. Avian influenza, salmonella, and foot and mouth disease are presented to illustrate the framework.
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spelling pubmed-31893942011-10-09 Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis Häsler, Barbara Howe, Keith S Stärk, Katharina DC BMC Health Serv Res Debate BACKGROUND: Surveillance and intervention are resource-using activities of strategies to mitigate the unwanted effects of disease. Resources are scarce, and allocating them to disease mitigation instead of other uses necessarily involves the loss of alternative sources of benefit to people. For society to obtain the maximum benefits from using resources, the gains from disease mitigation must be compared to the resource costs, guiding decisions made with the objective of achieving the optimal net outcome. DISCUSSION: Economics provides criteria to guide decisions aimed at optimising the net benefits from the use of scarce resources. Assessing the benefits of disease mitigation is no exception. However, the technical complexity of mitigation means that economic evaluation is not straightforward because of the technical relationship of surveillance to intervention. We argue that analysis of the magnitudes and distribution of benefits and costs for any given strategy, and hence the outcome in net terms, requires that mitigation is considered in three conceptually distinct stages. In Stage I, 'sustainment', the mitigation objective is to sustain a free or acceptable status by preventing an increase of a pathogen or eliminating it when it occurs. The role of surveillance is to document that the pathogen remains below a defined threshold, giving early warning of an increase in incidence or other significant changes in risk, and enabling early response. If a pathogen is not contained, the situation needs to be assessed as Stage II, 'investigation'. Here, surveillance obtains critical epidemiological information to decide on the appropriate intervention strategy to reduce or eradicate a disease in Stage III, 'implementation'. Stage III surveillance informs the choice, timing, and scale of interventions and documents the progress of interventions directed at prevalence reduction in the population. SUMMARY: This article originates from a research project to develop a conceptual framework and practical tool for the economic evaluation of surveillance. Exploring the technical relationship between mitigation as a source of economic value and surveillance and intervention as sources of economic cost is crucial. A framework linking the key technical relationships is proposed. Three conceptually distinct stages of mitigation are identified. Avian influenza, salmonella, and foot and mouth disease are presented to illustrate the framework. BioMed Central 2011-09-19 /pmc/articles/PMC3189394/ /pubmed/21929812 http://dx.doi.org/10.1186/1472-6963-11-225 Text en Copyright ©2011 Häsler et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Debate
Häsler, Barbara
Howe, Keith S
Stärk, Katharina DC
Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
title Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
title_full Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
title_fullStr Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
title_full_unstemmed Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
title_short Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
title_sort conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
topic Debate
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189394/
https://www.ncbi.nlm.nih.gov/pubmed/21929812
http://dx.doi.org/10.1186/1472-6963-11-225
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