Abstract:
Contemporary public health research demands a high level of methodological rigor. The use of theory based models allows researchers to formalize complex processes, strengthen the justification of hypotheses, and improve the quality of policy decisions. This is particularly relevant for disease prevention and the analysis of healthcare service delivery effectiveness under conditions of incomplete information. While clinical trials go through phases refining theory based hypotheses and gleaning evidences using particular gear mechanism, study of population health has to do with sociological behaviour related processes of quite different kind. The conspicuous definitive feature hard to evade is equilibrium based environment. In the paper we put into practicalities equilibrium based theory driven gear mechanisms related theoretical to empirical models.
Objective: To substantiate the relevance and advantages of applying theory based approach in public health research we illustrated two empirical studies: the effectiveness evaluation of a gastroduodenitis prevention program in patients with hypertension and the study of market efficiency of health services to the patients with atrial fibrillation.
Methods: In the first study, we used premorbid moral hazard theory and expected utility theory to develop equilibrium cost-effectiveness analysis (CEA) model. The second study based upon Dranove–Satterthwaite mode driven by production process theory. Using SEM approach we transformed it to empirical model to address issues of latent variables such as information noise, quality, comfort of health services, as well as demand elasticities as important constituents of theoretical model. directly Both studies involved patient samples and included retrospective and prospective elements. Evaluators given models complexity were Monte Corlo Markov Chain (MCMC) mostly Gibbs and Hamiltonian Dynamic samplers.
Results: Theoretical based approach enabled efficiency estimation by deviation from equilibrium. In first study it is defined as optimal trade-off between losses and gains due to increase of health services volume by unitswhile in the second market equilibrium pursued. Results indicated target groups of beneficiaries. At the whole efforts to prevent gastroduodenitis in elderly patients with essential hypertension proved to be cost-effective. Key effectiveness modifiers identified: compliance, age, hypertension stage, and participation in administered by state reimbursement program. In the atrial fibrillation pathways study, several hypotheses of the Dranove–Satterthwaite model were confirmed, indicating responsiveness of healthcare services to demand elasticities. Differences in patient preferences across clinical stages leading to equilibrium shifts were observed.
Conclusion: Theory based approach suggests powerful tools for enhancing the quality of public health research. Their application enables a deeper understanding of patient and provider behavior, supports the design of tailored interventions, and informs evidence-based health policy. The findings demonstrated that models of moral hazard and market interaction can be effectively applied to assess prevention programs and service delivery pathways within the Ukrainian healthcare context and presumably worldwide
