Buxton M J
Health Economics Research Group, Brunel University, Uxbridge, Middlesex, U.K.
Respir Med. 1991 Sep;85 Suppl B:43-6; discussion 57-8. doi: 10.1016/s0954-6111(06)80169-1.
The need for efficient use of resources in the provision of health care is now an accepted reality. Despite its economic significance, respiratory disease has been the subject of very few examples of the application of techniques of economic evaluation. There are a number of examples of cost-minimization studies, and these serve to emphasize that choices based on drug acquisition costs may be quite different from those based on the total costs of care. The difficulty of defining uni-dimensional measures of health outcome for respiratory disease has hampered the development of cost-effectiveness studies, and the future of these must lie with the efforts to develop measures of quality of life more appropriate to this area of medicine. But the multi-dimensional nature of relevant health outcomes suggests that cost-utility approaches are likely to play an important future role, as off attempts to directly establish patients' monetary valuations of the health benefits offered by new respiratory medicines.
在提供医疗保健服务时高效利用资源的必要性如今已成为公认的现实。尽管呼吸系统疾病具有经济重要性，但运用经济评估技术的实例却非常少。有一些成本最小化研究的实例，这些实例强调基于药品采购成本做出的选择可能与基于护理总成本做出的选择大不相同。难以定义呼吸系统疾病健康结果的单维度衡量标准阻碍了成本效益研究的发展，而此类研究的未来必定取决于开发更适用于该医学领域的生活质量衡量标准的努力。但相关健康结果的多维度性质表明，成本效用方法可能在未来发挥重要作用，比如尝试直接确定患者对新型呼吸系统药物所带来的健康益处的货币估值。
