The full content of Annals is available to subscribers

Subscribe/Learn More  >
Academia and the Profession |

A Clinician's Guide to Cost-Effectiveness Analysis

Allan S. Detsky, MD, PhD; and I. Gary Naglie, MD
[+] Article, Author, and Disclosure Information

Grant Support: By a National Health Research Scholar Award from Health and Welfare Canada (6606-2849-48) and by an Ontario Ministry of Health Research Personnel Development Program Fellowship (02448).

Requests for Reprints: Allan S. Detsky, MD, PhD, Toronto General Hospital, EN G-246, 200 Elizabeth Street, Toronto, Ontario M5G 2C4.

Current Author Addresses: Drs. Detsky and Naglie: Division of General Internal Medicine and Clinical Epidemiology, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4.

© 1990 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1990;113(2):147-154. doi:10.7326/0003-4819-113-2-147
Text Size: A A A

Cost-effectiveness analysis can be used to help set priorities for funding health care programs. For each intervention, the costs and clinical outcomes associated with that strategy must be compared with an alternate strategy for treating the same patients. If an intervention results in improved outcomes but also costs more, the incremental cost per incremental unit of clinical outcome should be calculated. The incremental cost-effectiveness ratios for various programs can be ranked to set funding priorities. By using this list, the person responsible for allocating resources can maximize the net health benefit for a target population derived from a fixed budget. Clinicians may not share this objective because, individually, they are appropriately concerned solely with the effectiveness of a specific intervention for their patients and are not concerned with the benefit derived from spending those resources on other patients in the target population. In addition, allocation may be driven by distributional and political objectives. Nevertheless, cost-effectiveness analysis demonstrates the consequences of allocation decisions. Because clinicians should participate in policy making, they must understand the role of this technique in setting funding priorities.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Journal Club
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.