Musgrove P
The World Bank, Population, Health and Nutrition Department, Washington, D.C. 20433, USA.
Salud Publica Mex. 1995 Jul-Aug;37(4):363-74.
The cost-effectiveness of a health intervention is an estimate of the relation between what it costs to be provided, and the improvement in health which results from such intervention. Health may improve because the incidence of illness or injury is reduced, because death is avoided or delayed, or because the duration or severity of disability is limited. The calculation of this health benefit combines objective factors, such as the age at incidence and whether or not the outcome is death, with subjective factors such as the severity of disability, the judgement as to the value of life lived at different ages, and the rate at which the future is discounted. The construction and interpretation of the estimate are explained. Also, the paper examines whether the concept of cost-effectiveness is consistent with ethical norms such as equity, and concludes that they are not in conflict. Finally, it addresses the question of how to incorporate cost-effectiveness into a health sector reform, and possible ways to implement it.
一项健康干预措施的成本效益是对提供该措施的成本与该干预措施所带来的健康改善之间关系的一种估计。健康状况的改善可能是因为疾病或伤害的发生率降低、死亡得以避免或推迟，或者残疾的持续时间或严重程度受到限制。这种健康效益的计算将客观因素（如发病年龄以及结果是否为死亡）与主观因素（如残疾的严重程度、对不同年龄段生活价值的判断以及对未来的贴现率）结合在一起。文中对该估计的构建和解释进行了说明。此外，本文还探讨了成本效益概念是否与公平等伦理规范相一致，并得出它们并不冲突的结论。最后，文章探讨了如何将成本效益纳入卫生部门改革以及可能的实施方式。
