Healthcare interventions to reduce inequities and inefficiencies in island regions: review and application in the Canary Islands

Full Title: Healthcare interventions to reduce inequities and inefficiencies in island regions: review and application in the Canary Islands

Funded by: Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC)

Granted amount: €8,406.50

Duration: 2 years (2025-2026)

Principal Investigator: Lidia García Pérez

Associated Researchers: Ignacio Abásolo Alessón, Miguel Ángel Negrín Hernández, Manuel Ridao López, Marta Guillén Toledano, Aránzazu Hernández Yumar, Benjamín Rodríguez Díaz, Carmen Guirado Fuentes, Cristina Valcárcel Nazco, Estefanía Herrera Ramos

Background:

Among the criteria for deciding to incorporate a technology, intervention, or program into the public healthcare service’s portfolio are efficiency or cost-effectiveness and equity. The type of study that provides information on the cost-effectiveness of a technology is economic evaluation, defined as a comparison of at least two alternatives in terms of costs and effects. However, there are certain trade-offs between efficiency and equity. This is especially evident in circumstances of insularity and/or geographical remoteness, where equitable access to healthcare often leads to inefficiencies. Similarly, focusing solely on efficiency can lead to neglecting some areas. Organizational interventions, such as telemedicine, the use of apps, or periodic campaigns where healthcare services are delivered throughout the territory (for example, by caravan), can help avoid inefficiencies and/or inequities. These interventions are often context-dependent, designed specifically for each territory based on its geographical characteristics and the way healthcare services are organized, and therefore are not directly applicable or transferable to other contexts. However, interventions implemented to address inefficiencies/inequities in island territories may share common features that could inspire solutions in other regions.

Objectives:

  1. Review the scientific literature to identify economic evaluations and interventions that could inspire the implementation of actions in the Canary Islands aimed at reducing inefficiencies/inequities caused by insularity.

  2. Understand and prioritize the economic evaluation needs of healthcare technologies identified by the Canary Islands health authorities regarding interventions already implemented or planned to reduce inefficiencies/inequities due to insularity.

  3. Propose an economic evaluation plan for interventions implemented or to be implemented in the Canary Islands to reduce inefficiencies/inequities caused by insularity, from both a social perspective and the perspective of the regional health system.

Methods:

To achieve the objectives, three methods will be applied sequentially:

  1. Systematic review of economic evaluations aimed at reducing inequities or inefficiencies in healthcare systems in island settings, with an assessment of the transferability of relevant economic evaluations.

  2. Survey of stakeholders (decision-makers) for the exploration and prioritization of economic evaluation needs in the public healthcare system of the Canary Islands.

  3. Drafting of an economic evaluation plan for interventions aimed at reducing inequities and inefficiencies related to insularity, based on the results of the first two methods. The plan will include protocols for the economic evaluation of the prioritized interventions and a timeline, and will be developed with the participation of the directly involved stakeholders.

Contact Person: Lidia García Pérez (lidia.garciaperez@sescs.es)