Garber A M, Phelps C E
Veterans Affairs Palo Alto Health Care System, CA, USA.
J Health Econ. 1997 Feb;16(1):1-31. doi: 10.1016/s0167-6296(96)00506-1.
To address controversies in the applications of cost-effectiveness analysis, we investigate the principles underlying the technique and discuss the implications for the evaluation of medical interventions. Using a standard von Neumann-Morgenstern utility framework, we show how a cost-effectiveness criterion can be derived to guide resource allocation decisions, and how it varies with age, gender, income level, and risk aversion. Although cost-effectiveness analysis can be a useful and powerful tool for resource allocation decisions, a uniform cost-effectiveness criterion that is applied to a heterogeneous population level is unlikely to yield Pareto-optimal resource allocations.
为了解决成本效益分析应用中的争议，我们研究了该技术背后的原理，并讨论了其对医疗干预评估的影响。使用标准的冯·诺依曼-摩根斯坦效用框架，我们展示了如何推导成本效益标准以指导资源分配决策，以及它如何随年龄、性别、收入水平和风险厌恶程度而变化。尽管成本效益分析对于资源分配决策可能是一个有用且强大的工具，但应用于异质人群层面的统一成本效益标准不太可能产生帕累托最优的资源分配。
