Hoel Michael
Department of Economics, University of Oslo, Norway.
Health Econ. 2003 Jul;12(7):601-8. doi: 10.1002/hec.733.
The criterion of cost-effectiveness in health management may be given a welfare-theoretical justification if people are risk neutral with respect to life years. With risk aversion, the optimal allocation of health expenditures changes: Compared to the cost-effective allocation, more resources should be allocated to health conditions for which the expected outcomes even after treatment are worse than average. The consequences of medical interventions are usually not known with certainty. Given this type of uncertainty, simple application of cost-effectiveness analysis would recommend maximization of expected health benefits given the health budget. We show that when people are risk averse with respect to the number of life years they live, the uncertainty associated with different types of interventions should play a role in allocating the health budget.
如果人们在生命年限方面是风险中性的，那么健康管理中的成本效益标准可以从福利理论的角度给出正当理由。在风险厌恶的情况下，健康支出的最优分配会发生变化：与成本效益分配相比，更多的资源应该分配到那些即使经过治疗预期结果仍低于平均水平的健康状况上。医疗干预的后果通常无法确切知晓。鉴于这种不确定性，简单应用成本效益分析会建议在健康预算既定的情况下实现预期健康效益的最大化。我们表明，当人们在其生存的生命年限数量方面是风险厌恶的时，与不同类型干预相关的不确定性在分配健康预算时应发挥作用。
