Principles of Cost-Effective Resource Allocation in Health Care organizations

Cost-effectiveness analysis (CEA) is a method of economic evaluation that can be used to assess the efficiency with which health care technologies use limited resources to produce health outputs. However, inconsistencies in the way that such ratios are constructed often lead to misleading conclusions when CEAs are compared. Some of these inconsistencies, such as failure to discount or to calculate incremental ratios correctly, reflect analytical errors that, if corrected, would resolve the inconsistencies. Others reflect fundamental differences in the viewpoint of the analysis. The perspectives of different decision-making entities can properly lead to different items in the numerator and denominator of the cost-effectiveness (C/E) ratio. Producers and consumers of CEA need to be more conscious of the perspectives of analysis, so that C/E comparisons from a given perspective are based upon a common understanding of the elements that are properly included.

[1]  G. Oster,et al.  Cost-effectiveness of antihyperlipemic therapy in the prevention of coronary heart disease. The case of cholestyramine. , 1987, JAMA.

[2]  M. Weinstein,et al.  Cost-effectiveness of interventions to prevent or treat coronary heart disease. , 1985, Annual review of public health.

[3]  M C Weinstein,et al.  Use and misuse of the term "cost effective" in medicine. , 1986, The New England journal of medicine.

[4]  J. C. Bell,et al.  Cost effectiveness of vaccination against pneumococcal pneumonia. , 1980, The New England journal of medicine.

[5]  M. Drummond,et al.  Health Care Technology: Effectiveness, Efficiency and Public Policy@@@Methods for the Economic Evaluation of Health Care Programmes , 1988 .

[6]  A. Elixhauser,et al.  Estimating Costs in the Economic Evaluation of Medical Technologies , 1990, International Journal of Technology Assessment in Health Care.

[7]  M C Weinstein,et al.  Economic Assessments of Medical Practices and Technologies , 1981, Medical decision making : an international journal of the Society for Medical Decision Making.

[8]  L Goldman,et al.  Cost-Effectiveness of Screening Strategies for Left Main Coronary Artery Disease in Patients with Stable Angina , 1988, Medical decision making : an international journal of the Society for Medical Decision Making.

[9]  E. Mishan Evaluation of Life and Limb: A Theoretical Approach , 1971, Journal of Political Economy.

[10]  D. Feeny,et al.  Utilities and Quality-Adjusted Life Years , 1989, International Journal of Technology Assessment in Health Care.

[11]  M. Weinstein,et al.  A cost-effectiveness analysis of exercise as a health promotion activity. , 1988, American journal of public health.

[12]  M. Weinstein,et al.  Allocation of Resources to Manage Hypertension , 1977 .

[13]  Daniel Drake History of a Case of Hydrophobia, Not Arising from an Ascertained Cause , 1831 .

[14]  G W Torrance,et al.  Economic evaluation of neonatal intensive care of very-low-birth-weight infants. , 1983, The New England journal of medicine.

[15]  Mark S. Thompson,et al.  Benefit-cost analysis for program evaluation , 1980 .

[16]  E. Keeler,et al.  Discounting of Life-Saving and Other Nonmonetary Effects , 1983 .

[17]  S. Schoenbaum,et al.  Benefit-Cost Analysis of Antimicrobial Prophylaxis in Abdominal and Vaginal Hysterectomy , 1983, JAMA.

[18]  M. Weinstein,et al.  Foundations of cost-effectiveness analysis for health and medical practices. , 1977, The New England journal of medicine.