Russell L B
Ciba Found Symp. 1985;110:203-17. doi: 10.1002/9780470720912.ch13.
This paper discusses some of the design issues that are most important as cost-effectiveness analysis of preventive care advances from a novel application of economic reasoning to become an accepted aid in decision-making. In this new role, cost-effectiveness studies must be more consistent in approach and more standardized in assumptions than they have been in the past, so that valid comparisons can be made on the basis of studies done by different authors, or by the same authors at different times. The paper discusses the issues of the perspective of the study; the choice of discount rate; medical care costs in added years of life; measurement of the costs of institutionalization; measures of health effects that reflect changes in the quality as well as the quantity of life; and the proper place of estimates of earnings. Proposals are made in each of these areas to help standardize future studies.
本文讨论了一些设计问题，这些问题在预防性保健的成本效益分析从经济推理的一种新应用发展成为决策中被广泛接受的辅助手段的过程中最为重要。在这个新角色中，成本效益研究在方法上必须比过去更加一致，在假设上更加标准化，以便能够在不同作者或同一作者在不同时间进行的研究基础上进行有效的比较。本文讨论了研究视角问题；贴现率的选择；延长寿命年份中的医疗保健成本；机构化成本的衡量；反映生活质量和数量变化的健康影响衡量指标；以及收入估计的恰当位置。针对这些领域中的每一个都提出了建议，以帮助规范未来的研究。
