Zarnke K B, Levine M A, O'Brien B J
Department of Medicine, London Health Sciences Centre, University of Western Ontario, Ontario, Canada.
J Clin Epidemiol. 1997 Jul;50(7):813-22. doi: 10.1016/s0895-4356(97)00064-4.
To assess whether health-care related economic evaluations labeled as "cost benefit analyses" (CBA) meet a contemporary definition of CBA methodology and to assess the prevalence of methods used for assigning monetary units to health outcomes.
Medline, Current Contents, and HSTAR databases and reference lists of review articles, 1991-1995.
Economic analyses labeled as CBAs were included. Agreement on study selection was assessed. STUDY EVALUATION: CBA studies were classified according to standard definitions of economic analytical techniques. For those valuing health outcomes in monetary units (bona fide CBAs), the method of valuation was classified.
53% of 95 studies were reclassified as cost comparisons because health outcomes were not appraised. Among the 32% considered bona fide CBAs, the human capital approach was employed to value health states in monetary units in 70%. Contingent valuation methods were employed infrequently (13%).
Studies labeled as CBAs in the health-care literature often offer only partial program evaluation. Decisions based only on resource costs are unlikely to improve efficiency in resource allocation. Among bona fide CBAs, the human capital approach was most commonly used to valuing health, despite its limitations. The results of health-care related CBAs should be interpreted with extreme caution.
评估标记为“成本效益分析”（CBA）的医疗保健相关经济评估是否符合CBA方法的当代定义，并评估用于为健康结果赋予货币单位的方法的流行程度。
1991年至1995年的Medline、《现刊目次》和HSTAR数据库以及综述文章的参考文献列表。
纳入标记为CBA的经济分析。评估了研究选择的一致性。
根据经济分析技术的标准定义对CBA研究进行分类。对于那些用货币单位评估健康结果的研究（真正的CBA），对评估方法进行了分类。
95项研究中有53%被重新归类为成本比较，因为未对健康结果进行评估。在被视为真正CBA的32%的研究中，70%采用人力资本方法用货币单位评估健康状态。很少使用意愿评估法（13%）。
医疗保健文献中标记为CBA的研究通常仅提供部分项目评估。仅基于资源成本的决策不太可能提高资源配置效率。在真正的CBA中，尽管存在局限性，但人力资本方法最常用于评估健康。与医疗保健相关的CBA结果应极其谨慎地解读。
