The Principles and Objectives of Cost-Effectiveness Analysis

1968 ◽  
Vol 72 (685) ◽  
pp. 43-53 ◽  
Author(s):  
A. Stratton

The terms “cost-effectiveness” and to a lesser degree “cost-benefit” analysis have become familiar words in the technical and national press, the former usually in relation to defence projects—the latter in relation to social projects, such as transport, power generation and building. Indeed, at the time of the last General Election the political correspondent of a national newspaper wrote, “Mr. Heath and Mr. Callaghan, Chancellor of the Exchequer, vied with each other in stressing the importance of cost-effectiveness, which used to be known as getting value for money”. The apparently simple concept of “value for money” raises three important issues: (i) how is “value” of defence and social projects quantified? (ii) what is the “money” involved, i.e. what are all the relevant costs? and (iii) what are the information and decision processes that are used in attempting to obtain “value for money“?

1974 ◽  
Vol 4 (2) ◽  
pp. 325-352 ◽  
Author(s):  
Herbert E. Klarman

As an economic technique for evaluating specific projects or programs in the public sector, cost-benefit analysis is relatively new. In this paper, the theory and practice of cost-benefit analysis in general are discussed as a basis for considering its role in assessing technology in the health services. A review of the literature on applications of cost-benefit or cost-effectiveness analysis to the health field reveals that few complete studies have been conducted to date. It is suggested that an adequate analysis requires an empirical approach in which costs and benefits are juxtaposed, and in which presumed benefits reflect an ascertained relationship between inputs and outputs. A threefold classification of benefits is commonly employed: direct, indirect, and intangible. Since the latter pose difficulty, cost-effectiveness analysis is often the more practicable procedure. After summarizing some problems in predicting how technologic developments are likely to affect costs and benefits, the method of cost-benefit analysis is applied to developments of health systems technology in two settings-the hospital and automated multiphasic screening. These examples underscore the importance of solving problems of measurement and valuation of a project or program in its concrete setting. Finally, barriers to the performance of sound and systematic analysis are listed, and the political context of decision making in the public sector is emphasized.


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