Clinical Excellence Research Center, Stanford School of Medicine.
New York Academy of Medicine.
Health Psychol. 2019 Aug;38(8):672-679. doi: 10.1037/hea0000769.
Health care remains the most expensive sector in the U.S. economy, now accounting for nearly 1 in every 5 dollars spent. The purpose of health care is to improve the health of populations. However, formal medical care is one of many alternatives for improving health. In order to make better use of scarce resources, cost-effectiveness methodologies have been developed to evaluate how to produce the most health within the constraints of available resources. Standardized cost-effectiveness methodologies are now commonly used in the evaluation of medical therapies and new technologies. However, these methods have rarely been employed for the evaluation of behavioral interventions. Behavioral interventions often use measures that are not generally applied in other areas of health outcomes research. A consequence of neglecting to employ standardized cost-effectiveness analysis is that behavioral, psychological, and environmental interventions may be left out of resource allocation discussions. The purpose of this paper is to review standardized approaches to cost-effectiveness analysis and to encourage their use for the evaluation of behavioral intervention programs. Application of standardized methods of cost-effectiveness analysis will allow direct comparisons between investing in behavioral interventions programs in comparison to a wide range of other alternatives. The methods are general and can be used to estimate the cost-effectiveness of social and environmental interventions in addition to traditional medical and surgical treatments. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
医疗保健仍然是美国经济中最昂贵的部门,现在占每 5 美元支出的近 1 美元。医疗保健的目的是改善人口的健康状况。然而,正规医疗是改善健康的众多选择之一。为了更好地利用稀缺资源,已经开发了成本效益方法来评估如何在可用资源的限制内产生最多的健康。标准化的成本效益方法现在常用于医疗疗法和新技术的评估。然而,这些方法很少用于行为干预的评估。行为干预通常使用的措施在健康结果研究的其他领域并不常用。忽略采用标准化成本效益分析的后果是,行为、心理和环境干预可能被排除在资源分配讨论之外。本文的目的是回顾标准化的成本效益分析方法,并鼓励将其用于行为干预计划的评估。应用标准化的成本效益分析方法将允许将投资于行为干预计划与广泛的其他替代方案进行直接比较。这些方法具有普遍性,可以用于估计社会和环境干预措施的成本效益,除了传统的医疗和手术治疗。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。