Leander R Buisman

• PhD
• PostDoc Position at Erasmus University Rotterdam

Objectives: There is little specific guidance on performing an early cost-effectiveness analysis (CEA) of medical tests. We developed a framework with general steps and applied it to two cases. Methods: Step 1 is to narrow down the scope of analysis by defining the test's application, target population, outcome measures, and investigating current...

Background: The goal of universal health coverage (UHC) requires inter alia that families who get needed health care do not suffer undue financial hardship as a result. This can be measured by the percentage of people in households whose out-of-pocket health expenditures are large relative to their income or consumption. We aimed to estimate the g...

There have been steep falls in rates of child stunting in much of Sub-Saharan Africa (SSA). Using Demographic and Health Survey data, we document significant reductions in stunting in seven SSA countries in the period 2005-2014. For each country, we distinguish potential determinants that move in a direction consistent with having contributed to th...

The cost-effectiveness of clinical interventions is often assessed using current care as the comparator, with national guidelines as a proxy. However, this comparison is inadequate when clinical practice differs from guidelines, or when clinical practice differs between hospitals. We examined the degree of variation in the way patients with a recen...

Objective We estimated the cost-effectiveness of novel imaging tests to select patients for carotid endarterectomy (CEA) in patients with significant carotid stenosis using a computer model and explored the minimum prognostic performance that a new confirmatory test must have in order to be cost-effective versus the guideline-based strategy. Metho...

This article assesses trends and inequalities in maternal and child health in the Philippines between 1993 and 2013, using 6 national household surveys, and also compares the Philippines’ performance to 15 other Asia-Pacific countries. Thirteen indicators of child health outcomes and maternal and child health interventions are examined. Two measure...

Objective To evaluate direct and indirect costs per quality adjusted life year (QALY) for different initial treatment strategies in very early RA. Methods The 1-year data of the treatment in the Rotterdam Early Arthritis Cohort trial were used. Patients with a high probability (>70%) according to their likelihood of progressing to persistent arthr...

Background: There is a lack of information about the sensitivity, specificity and costs new diagnostic tests should have to improve early diagnosis of rheumatoid arthritis (RA). Our objective was to explore the early cost-effectiveness of various new diagnostic test strategies in the workup of patients with inflammatory arthritis (IA) at risk of h...

The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, i...

The last few years have seen a growing commitment worldwide to universal health coverage (UHC). Yet there is a lack of clarity on how to measure progress towards UHC. We propose a ‘mashup’ index that captures both aspects of UHC: that everyone—irrespective of their ability-to-pay—gets the health services they need; and that nobody suffers undue fin...

Objective: This early Health Technology Assessment study assesses the short term cost-effectiveness of 4 add-on diagnostic tests in early inflammatory arthritis patients at risk of RA. Methods: We modeled four diagnostic add-on tests to the ACR/EULAR 2010 RA classification criteria covering the first year after diagnosis, using REACH data. Sensi...

Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens’ rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already “reached” universal health c...

There have been no ischemic stroke costing studies since major improvements were implemented in stroke care. We therefore determined hospital resource use and costs of ischemic stroke and TIA in the Netherlands for 2012. We conducted a retrospective cost analysis using individual patient data from a national diagnosis-related group registry. We ana...

Background and Purpose: Non-invasive molecular imaging tests are being developed to improve the ability to predict future strokes in patients with a recent transient ischemic attack (TIA) or minor ischemic stroke. Greater predictive ability can improve patient management, e.g., by identifying which patients will benefit more from a carotid endarter...

This paper provides evidence about socioeconomic inequity in inpatient healthcare utilisation in South Africa after 10 years of reform after Apartheid, and examines which are the contributing determinants. We use the South African sample of the World Health Survey from 2002–03 and estimate horizontal inequity in inpatient healthcare utilisation usi...

Objectives: There have been no ischemic stroke costing studies since major improvements were implemented in stroke care. We therefore determined hospital resource use and costs of ischemic stroke and TIA in the Netherlands for 2012. Methods: We conducted a retrospective cost analysis using individual patient data from a national diagnosis-related g...

We examine differential progress on health Millennium Development Goals (MDGs) between the poor and the better off within countries. Our findings are based on an original analysis of 235 DHS and MICS surveys spanning 64 developing countries over the 1990–2011 period. We track five health status indicators and seven intervention indicators from all...

Global progress in reducing the burden of undernutrition tends to be measured at the population level. It has been hypothesized that population-level improvements may mask widening socioeconomic inequalities, but little attempt has been made to assess whether this is true. Original data from 131 demographic health surveys and 48 multiple indicator...

This paper looks at differential progress on the health Millennium Development Goals between the poor and better-off within countries. The findings are based on original analysis of 235 Demographic and Health Surveys and Multiple Indicator Cluster Surveys, spanning 64 developing countries over the period 1990-2011. Five health status indicators and...

This paper uses a common household survey instrument and a common set of imputation assumptions to estimate the pro-poorness of government health expenditure across 69 countries at all levels of income. On average, government health expenditure emerges as significantly pro-rich, but there is heterogeneity across countries: in the majority, governme...

VALUE IN HEALTH 16 (2013) A323–A636 A563 OBJECTIVES: Several technologies are currently being developed for better stratifying individuals at risk of developing Rheumatoid Arthritis (RA) to patient-tailored treatment. We assessed the potential cost-effectiveness of four technologies (MRI, il6-serum test, RNA B-cell signature, genetic assay) applied...