How to use the results of an economic evaluation

被引:21
作者
Heyland, DK
Gafni, A
Kernerman, P
Keenan, S
Chalfin, D
机构
[1] Queens Univ, Dept Med, Kingston, ON K7L 3N6, Canada
[2] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
[3] McMaster Univ, Ctr Hlth Econ & Policy Anal, Hamilton, ON, Canada
[4] Univ Toronto, Dept Med, Toronto, ON, Canada
[5] Hlth Sci Ctr, Dept Med, London, ON, Canada
[6] Albert Einstein Coll Med, Beth Israel Med Ctr, Dept Med, New York, NY USA
关键词
economic evaluations; cost analysis; cost benefit; cost-effectiveness analysis; critical care; intensive care; critical appraisal;
D O I
10.1097/00003246-199906000-00052
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Given the high costs of delivering care to critically ill patients, practitioners and policymakers are beginning to scrutinize the costs and outcomes associated with intensive care. Health economics is a discipline concerned with determining the best way of using resources to maximize the health of the community. This involves addressing questions such as which procedure, test, therapy, or program should be provided, and to whom, given available resources. Purpose: The purpose of this article is to review general economic principles that will help intensivists to better interpret published economic evaluations. Data Sources: Selected articles from the health economics and critical care literature. Results: In this article, we use an economic evaluation that examines sedation strategies in critically ill patients. We discuss how learning to critically appraise an economic evaluation is only part of the task for end users. Determining whether and how to apply the results of economic evaluations to local settings presents bigger challenges and remains largely a matter of judgment, Conclusions: Economic evaluations use analytic techniques to systematically consider all possible costs and consequences of clinical actions, Although they should never form the sole basis for clinical decisions for individual patients, economic evaluations offer potentially useful information at different levels of decision-making.
引用
收藏
页码:1195 / 1202
页数:8
相关论文
共 37 条
[1]   PROPOFOL VS MIDAZOLAM IN SHORT-TERM, MEDIUM-TERM, AND LONG-TERM SEDATION OF CRITICALLY ILL PATIENTS - A COST-BENEFIT-ANALYSIS [J].
CARRASCO, G ;
MOLINA, R ;
COSTA, J ;
SOLER, JM ;
CABRE, L .
CHEST, 1993, 103 (02) :557-564
[2]   MECHANICAL VENTILATION FOR THE ELDERLY PATIENT IN INTENSIVE-CARE - INCREMENTAL CHARGES AND BENEFITS [J].
COHEN, IL ;
LAMBRINOS, J ;
FEIN, IA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (08) :1025-1029
[3]   How to use an article on therapy or prevention: Pneumonia prevention using subglottic secretion drainage [J].
Cook, DJ ;
Hebert, PC ;
Heyland, DK ;
Guyatt, GH ;
BrunBuisson, C ;
Marshall, JC ;
Russell, J ;
Vincent, JL ;
Sprung, CL ;
Rutledge, F .
CRITICAL CARE MEDICINE, 1997, 25 (09) :1502-1513
[4]   RESULTS, CHARGES, AND BENEFITS OF INTENSIVE-CARE FOR CRITICALLY ILL PATIENTS - UPDATE 1983 [J].
CULLEN, DJ ;
KEENE, R ;
WATERNAUX, C ;
KUNSMAN, JM ;
CALDERA, DL ;
PETERSON, H .
CRITICAL CARE MEDICINE, 1984, 12 (02) :102-106
[5]  
CULLEN DJ, 1977, ANESTHESIOLOGY, V47, P203, DOI 10.1097/00000542-197708000-00011
[6]   The effect of ICU sedation guidelines and pharmacist interventions on clinical outcomes and drug cost [J].
Devlin, JW ;
Holbrook, AM ;
Fuller, HD .
ANNALS OF PHARMACOTHERAPY, 1997, 31 (06) :689-695
[7]  
Drummond M., 2015, METHODS EC EVALUATIO, V4
[8]   Users' guides to the medical literature .13. How to use an article on economic analysts of clinical practice .A. Are the results of the study valid? [J].
Drummond, MF ;
Richardson, WS ;
OBrien, BJ ;
Levine, M ;
Heyland, D .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 277 (19) :1552-1557
[9]  
Drummond MF, 1987, METHODS EC EVALUATIO, P18
[10]   A PROPOSED MODEL FOR THE COST OF CARDIOPULMONARY-RESUSCITATION [J].
EBELL, MH ;
KRUSE, JA .
MEDICAL CARE, 1994, 32 (06) :640-649