Sachdeva R C
Centre for Outcomes Research and Quality Management, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
Indian J Pediatr. 2001 Apr;68(4):339-42. doi: 10.1007/BF02721841.
The estimation of cost-effectiveness of pediatric critical care services is an extremely relevant issue for both developing and industrialized nations. Pediatric critical care is expensive and the long outcomes are still relatively unclear. From the perspective of patients who receive the benefits of these services, there may be little controversy regarding cost-effectiveness. However, the issue becomes very complex when attempts are made to identify which patients will benefit most. This also needs to be considered while developing public policy when decisions for allocation of limited resources need to be made within health care systems, and choices need to be made between the provision of health care and other public services. This article addresses the complex issue of economic evaluations and describes various type of cost analyses. The difference between charges and costs is defined, and a discussion of the measurement of costs and benefits, and their relationship to outcomes research is provided. Although there is not a unique answer to the issue of cost-effectiveness for pediatric critical care services, the available literature particularly from the United States is summarized, and the ethical implications explored.
对发展中国家和工业化国家而言，评估儿科重症监护服务的成本效益都是一个极其重要的问题。儿科重症监护成本高昂，而长期效果仍相对不明朗。从受益于这些服务的患者角度来看，成本效益方面可能争议不大。然而，当试图确定哪些患者将获益最多时，问题就变得非常复杂。在制定公共政策时，当需要在医疗保健系统内做出有限资源分配决策，以及需要在提供医疗保健和其他公共服务之间做出选择时，这一点也需要加以考虑。本文探讨了经济评估这一复杂问题，并描述了各种类型的成本分析。定义了收费与成本之间的差异，并讨论了成本和效益的衡量方法，以及它们与结果研究的关系。尽管儿科重症监护服务的成本效益问题没有唯一答案，但本文总结了现有文献，特别是来自美国的文献，并探讨了其中的伦理意义。
