Академический Документы
Профессиональный Документы
Культура Документы
• Advantages
1. Compare $$$ costs vs. $$$ benefits
2. Assess one program or compare multiple
3. Compare very different types of projects
- disparate outcomes
• Disadvantages
1. All benefits need a $$$ value
• including lives saved
• researchers argue how to do this
Cost - Benefit Analysis (CBA)
• Direct Medical
• Direct Non-medical
- include program set-up costs
• Similar to the other methods
• “Get ‘em all!”
• Measure resource units & “price them out”
• MD visits,
• ER visits,
• Inpatient days
Identifying Benefits
1. “Direct” benefits:
- medical & non-medical resources saved
- a “benefit” can be a “cost” “avoided”
- ex: immunizations
- Perspective dependent
2. “Indirect” benefits:
- “gained” productivity time x average wages
- consider the Pt and caregivers
- sometimes court awards have been used
Cost - Benefit Analysis (CBA)
3. Intangible benefits
- pain and suffering
- only through WTP (scenario provided)
- strategies to estimate the value
• open-ended
• close-ended
• bidding
• payment cards
- disadvantages: hypothetical case and bias
Calculating results
Medical costs
Varicella disease costs 90 10 (80)
Vaccine and administration 0 88 88
Total Medical Costs 90 98 8
Lieu TA, Cochi SL, Black SB, Halloran ME, Shinefield HR, Holmes SJ, Wharton M, Washington AE. Cost-effectiveness of a routine varicella vaccination
program for US children. JAMA; 1994 Feb 2;271(5):375-81.
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