IHE Publications

The diagonal approach: A theoretic framework for economic evaluation of vertical and horizontal interventions in healthcare

The diagonal approach is a health system funding concept wherein vertical approaches targeting specific diseases are combined with horizontal approaches intended to strengthen health systems broadly.  This paper aims to develop a theoretical framework for the diagonal approach. It allows concurrent evaluation of three different types of horizontal interventions, those: (i) improving health system efficiency, (ii) improving capacity, and (iii) investing in new platforms. The diagonal approach framework defines decision problems flexibly and realistically, forming the basis for future applied work. It captures spillovers, returns to scale, and dynamic effects. Dynamic examples are provided to demonstrate the advantages of the diagonal approach over prior frameworks. The diagonal approach framework defines decision problems flexibly and realistically, forming the basis for future applied work. Implementation using this framework would improve resource allocation and patient health outcomes.

Publication Type: Journal Articles

Year of Publication: 2022

Topics: Constraints, Cost-effectiveness analysis, Diagonal approach, Economic Evaluation, Spillover effects

Authors: Erin Kirwin, Rachel Meacock, Jeff Round, Matt Sutton

Journal Title: Social Science and Medicine