Health care economic analyses and value-based medicine

被引:162
作者
Brown, MM
Brown, GC
Sharma, S
Landy, J
机构
[1] Ctr Value Based Med, Flourtown, PA 19031 USA
[2] Thomas Jefferson Univ, Jefferson Med Coll, Wills Eye Hosp, Retina Vasc Unit, Philadelphia, PA 19107 USA
[3] Queens Med Coll, Ctr Ocular Cost Effect Hlth Policy, Kingston, ON, Canada
关键词
cost-effectiveness analysis; cost-utility analysis; ophthalmology; quality-adjusted life year (QALY); quality of life; utility values; value-based medicine;
D O I
10.1016/S0039-6257(02)00457-5
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Health care economic analyses are becoming increasingly important in the evaluation of health care interventions, including many within ophthalmology. Encompassed with the realm of health care economic studies are cost-benefit analysis, cost-effectiveness analysis, cost-minimization analysis, and cost-utility analysis. Cost-utility analysis is the most sophisticated form of economic analysis and typically incorporates utility values. Utility values measure the preference for a health state and range from 0.0 (death) to 1.0 (perfect healthy). When the change in utility measures conferred by a health care intervention is multiplied by the duration of the benefit, the number of quality-adjusted life-years (QALYs) gained from the intervention is ascertained. This methodology incorporates both the improvement in quality of life and/or length of life, or the value, occurring as a result of the intervention. This improvement in value can then be amalgamated with discounted costs to yield expenditures per quality-adjusted life-year ($/QALY) gained. $/QALY gained is a measure that allows a comparison of the patient-perceived value of virtually all health care interventions for the dollars expended. A review of the literature on health care economic analyses, with particular emphasis on cost-utility analysis, is included in the present review. It is anticipated that cost-utility analysis will play a major role in health care within the coming decade.
引用
收藏
页码:204 / 223
页数:20
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