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  1. Cost-effectiveness analysis in surgery.

    Article - En anglais

    Background

    With tighter constraints on health care spending, many recognize the need to identify and restrict clinical interventions that are not cost-effective.

    As a result, cost-effectiveness analysis is being used increasingly to assess the relative value of surgical interventions.

    Methods and Results

    We first present the general concept of cost-effectiveness analysis and review a recent study of carotid endarterectomy to demonstrate the technique.

    We next consider the classic application of cost-effectiveness analysis to resource-allocation decisions and use the Oregon Medicaid experiment to illustrate some potential problems with this approach.

    We then present the current role of cost-effectiveness analysis : informing decisions about individual interventions that are new, controversial, or in direct competition with an accepted alternative treatment.

    Finally, we review several limitations of the methods used to measure costs and benefits and discuss problems with the interpretation of cost-effectiveness studies.

    Conclusions

    Cost-effectiveness analysis is a systematic approach to assessing the relative value of health care interventions.

    This technique is being used increasingly to frame clinical policy decisions in surgery.

    Because of this, surgeons need to understand cost-effectiveness analysis and be prepared to examine these studies critically.

    Mots-clés Pascal : Chirurgie, Soin intégré, Approche déterministe, Coût exploitation, Critère décision, Application médicale, Evaluation, Homme, Economie santé

    Mots-clés Pascal anglais : Surgery, Managed care, Deterministic approach, Operating cost, Decision criterion, Medical application, Evaluation, Human, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0144574

    Code Inist : 002B25N. Création : 21/07/1998.