Jönsson B
Ciba Found Symp. 1985;110:22-37.
The role of economic analysis is not only to estimate the economic consequences of preventive programmes, their costs and benefits, but also to contribute to an understanding of individual and collective choice in allocating resources to prevention. A basic economic concept of relevance for prevention is investment. For investments, costs will always precede benefits in time. This means that the choice of discount rate is of great importance for the value of prevention. The identification and evaluation of costs for preventive programmes has its special problems. The 'opportunity cost' of time is important, both for a correct estimation of the social costs of preventive programmes and for an understanding of individual behaviour in relation to prevention. 'Willingness to pay' is the basic concept in the economic evaluation of benefits from prevention. The use of this concept in health care has been criticized, but it is preferable to indirect methods of benefit evaluation. However, for many preventive programmes, it is sufficient to study cost-effectiveness. The distributional consequences of different measures of effectiveness have to be recognized, as well as the role of prevention in reducing inequalities in health in general.
经济分析的作用不仅在于估计预防项目的经济后果、成本和收益，还在于有助于理解在将资源分配给预防工作时的个人和集体选择。与预防相关的一个基本经济概念是投资。对于投资而言，成本在时间上总是先于收益。这意味着贴现率的选择对于预防的价值至关重要。预防项目成本的识别和评估有其特殊问题。时间的“机会成本”很重要，这对于正确估计预防项目的社会成本以及理解个人在预防方面的行为都很重要。“支付意愿”是预防收益经济评估中的基本概念。这一概念在医疗保健中的使用受到了批评，但它比间接的收益评估方法更可取。然而，对于许多预防项目来说，研究成本效益就足够了。必须认识到不同效果衡量措施的分配后果，以及预防在总体上减少健康不平等方面的作用。
