Suchergebnisse

A growing body of research indicates that prevention offers the promise of better ways to maintain health and extend life. In this timely volume, Louise B. Russell shows that preventive measures are not as simple as often depicted--while many do improve health, they are not without risk or cost, and in fact rarely reduce medical expenditures. Each measure, she argues, must be evaluated individually and in all its dimensions: health benefits, health risks, and resource costs. To demonstrate the many factors involved in evaluating preventive measures, Russell examines the policy debates about smallpox and measles vaccination, screening and drug therapy for hypertension, and exercise. She uses these case studies to explain the methods of cost-effectivness analysis, showing how the choice among health investments can be made a more rational exercise. The volume concludes with a suggested framework for the design of future cost-effectiveness evaluations. Policymakers in and out of the health field will benefit from this lucid examination of the potential of prevention for improving health and changing the allocation of limited resources.

Despite spending far more on medical care, Americans live shorter lives than the citizens of other high-income countries. The situation has been getting worse for at least three decades. This paper describes the main scientific methods for guiding the allocation of resources to health - cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA), sketches their methodological progress over the last several decades, and presents examples of how medical practice in other high-income countries, where people live longer, follows the priorities indicated by cost-effectiveness analysis. CEA and CBA support democratic decision-making processes, which have themselves benefited from scientific inquiry; these are touched on at the end of the paper.