Uploaded by richel091250 on Mar 24, 2008
http://www.pcp.onlinemindanao.com
Health economics is a logical and explicit framework to aid health care workers, decision-makers, government or society at large to make choices on how to best use resources.
All healthcare workers are involved in making decisions about resource allocation everyday, many times a day. in the Philippines where health expenditure is mainly out-of-pocket, the doctors acts as a health economist and guides the patient on which interventions would yield maximum results for his patient's budget. With the increasing number of options for diagnostic or therapeutic interventions and the increasing size of a family's budgetary allocation for health, familiarity with the different methods of economic evaluation has become very useful.
The 4 main methods of economic evaluation are cost-benifit, cost-minimization, cost-effectiveness and cost-utility analysis. These methods examine one (or more) possible interventions and compare the inputs or resources necessary to carry out such interventions with their consequences and effects. The various methods of economic evaluation differ in the way they itemize and value inputs and consequences. Cost-benifit analysis express both the inputs and consequences in monetary terms. Cost-minimization analysis can be carried out if the consequences or interventions are the same and only the inputs are taken into consideration. The aim is to decide the cheapest way to achieve the same outcome. Cost-effectiveness analysis can be carried out when the consequences of different interventions vary but can be measured in identical units and inputs are costed. Competing interventions are compared in terms of cost per unit consequence. Cost-utility analysis can be carried out when the consequences are expressed in terms of quality and quantity of life. Of these, cost-minimization analysis is the easiest to apply when making decisions at the bedside or in the clinic.
Faced with different options for his patients, the doctor acts as a manager and based on the baseline risk of his patient, ranks the different options in terms of relative risk reduction, absolute risk reduction and cost of treatment, recommends the interventions suited to the patient's budget by explaining the options in terms the patient can understand then shares the decision-making with the patient.
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