Detecting Dominant Alternative Interventions to Reduce Treatment Costs

Medical interventions can be compared attending to their health benefits and costs but also considering the similarity of the clinical actions involved. An intervention is a dominant alternative with respect to another intervention if it is better and cheaper. In this paper we introduce a hierarchy of medical actions that provides the semantics required by a methodology to detect dominant alternative interventions. After a formal introduction of this methodology, it is applied to analyze the data about the long term treatment of hypertension in the health care center ABS Vandellos-l'Hospitalet de l'Infant (Spain) in the years 2005-2009 in order to analyze feasible cost reductions after replacing medical interventions by their corresponding optimal, observed, dominant alternatives. This study shows that the use of this methodology reduces the average cost of each clinical encounter in €1.37.