Are we ready to use cost-effectiveness analysis in health care decision-making? A health services research challenge for clinicians, patients, health care systems, and public policy.

The dominance of managed care as an organizing principle for health care delivery suggests that cost-effectiveness analysis (CEA) may be applied increasingly to decision-making at all levels. Health services researchers now need to address questions of how to further the underlying methods of CEA, how to make it a more practical tool for market-based as well as public policy decisions, and how to enhance CEA's ability to lead to responsible decisions that result in more effective and efficient care.