SEARCH · PubMed Health

Results for “Cost Benefit Analysis”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMed1986

A comparison of alternative mosquito abatement methods using benefit-cost analysis.

Benefit-cost analysis can be used to evaluate and compare projects that involve alternative mosquito control methods. A comparison of two such projects in Chatham County, GA indicated that source reduction was a contributing factor in the reduction of ground adulticide applications and quantities, and annual female densities per light-trap night of the predominant saltmarsh mosquito species in the area. Net benefits realized from source reduction were $591,319 as opposed to $409,823 and discounted net benefits were $377,729 versus $284,511 (source reduction project vs. chemical control project) demonstrating the relative effectiveness of the source reduction project in our application. Because of unique differences between areas and projects, generalizations of the above conclusion are cautioned, although the approach is easily adapted.

Cost-Benefit Analysis↗

PubMed2002

Is it really possible to build a bridge between cost-benefit analysis and cost-effectiveness analysis?

Cost-benefit analysis (CBA) is a recognised as the economic evaluation technique that accords most with the underlying principles of standard welfare economic theory. However, due to problems associated with the technique, economists evaluating resources allocation decisions in health care have most often used cost-effective analysis (CEA), in which health benefits are expressed in non-monetary units. As a result, attempts have been made to build a welfare economic bridge between cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA). In this paper, we develops these attempts and finds that, while assumptions can be made to facilitate a constant willingness-to-pay per unit of health outcome, these restrictions are highly unrealistic. We develop an impossibility theorem that shows it is not possible to link CBA and CEA if: (i) the axioms of expected utility theory hold; (ii) the quality-adjusted life-year (QALY) model is valid in a welfare economic sense; and (iii) illness affects the ability to enjoy consumption. We conclude that, within a welfare economic framework, it would be unwise to rely on a link between CBA and CEA in economic evaluations.

Cost-Benefit Analysis↗

PubMed1977

Evaluation of surgical therapy by cost-benefit analysis.

Cost-benefit analysis (CBA) is described briefly, emphasizing the contribution this technique can make in justifying health care programs vying with other costly public programs for support. Costs and benefits of two surgical diagnostic techniques are outlined briefly as illustrations of the analysis. The first analyzes routine intraoperative cholangiography indicating the slight benefits that accrue from its use in terms of mortality and hospital expense. A more complicated example is an analysis of a policy of universal annual uterine cervical smears in asymptomatic women for cancer prevention where, granted the assumptions of the model, the costs minus the benefits of the program are estimated to be $565,000/beneficiary/year. The average beneficiary will gain 22 years of life at an average cost/year of about $26,000. The two examples are presented primarily as illustrations of a methodology which is being applied widely in medicine and public policy planning. Second, the marshalling of facts in CBA of a policy of annual uterine smears is of interest to those concerned with the justification of this screening procedure.

Adult↗

PubMed1979

Cancer chemotherapy in advanced malignant disease. A cost benefit analysis.

A cost benefit analysis of chemotherapy in unselected patients with advanced malignant disease originating in a defined population (250 000 inhabitants) demonstrated that the use of this therapy as the main treatment in hospitalised patients increased from a few per cent during 1973 to 60 per cent during 1977, corresponding to an increase in the cost of drugs from 10 000 to 200 000 dollars. At the same time the capacity for hospital care of patients with advanced malignancies increased from 317 to 488 patients without any enlargement of other resources. As more than 90 per cent of the medical budget consists of expenditures for salaries and localities, a cheaper medical care was obtained, but, above all, the survival rate and the quality of life for many patients was improved.

Adult↗

PubMed1993

Cost-benefit analysis.

Cost-benefit analysis is probably the most comprehensive method of economic evaluation available and it can be applied in two ways. The human capital approach means that the value of people's contributions is linked to what they are paid. The approach based on individuals' observed or stated preference means that their personal valuations are placed on an activity by assessing how much money they are prepared to accept for an increased risk or to pay for a particular service. Each method has its disadvantages and the most successful that has been devised so far is the "willingness to pay" (stated preference) approach, though the response to this is to a large extent dependent on the income of the person being questioned. There are still problems with its application, however, so its usefulness is limited.

Cost of Illness↗

PubMed2006

Democracy and sustainable development--what is the alternative to cost-benefit analysis?

Cost-benefit analysis (CBA) is part of neoclassical economics, a specific paradigm, or theoretical perspective. In searching for alternatives to CBA, competing theoretical frameworks in economics appear to be a natural starting point. Positional analysis (PA) as an alternative to CBA is built on institutional theory and a different set of assumptions about human beings, organizations, markets, etc. Sustainable development (SD) is a multidimensional concept that includes social and ecological dimensions in addition to monetary aspects. If the political commitment to SD in the European Union and elsewhere is taken seriously, then approaches to decision making should be chosen that 1st open the door for multidimensional analysis rather than close it. Sustainable development suggests a direction for development in a broad sense but is still open to different interpretations. Each such interpretation is political in kind, and a 2nd criterion for judging different approaches is whether they are ideologically open rather than closed. Although methods for decision making have traditionally been connected with mathematical objective functions and optimization, the purpose of PA is to illuminate a decision situation in a many-sided way with respect to possibly relevant ideological orientations, alternatives, and consequences. Decisions are understood in terms of matching the ideological orientation of each decision maker with the expected effects profile of each alternative considered. Appropriateness and pattern recognition are other concepts in understanding this process.

Conservation of Natural Resources↗

PubMed1996

Global eradication of poliomyelitis: benefit-cost analysis.

A benefit-cost analysis of the Poliomyelitis Eradication Initiative was undertaken to facilitate national and international decision-making with regard to financial support. The base case examined the net costs and benefits during the period 1986-2040; the model assumed differential costs for oral poliovirus vaccine (OPV) and vaccine delivery in industrialized and developing countries, and ignored all benefits aside from reductions in direct costs for treatment and rehabilitation. The model showed that the "break-even" point at which benefits exceeded costs was the year 2007, with a saving of US$ 13 600 million by the year 2040. Sensitivity analyses revealed only small differences in the break-even point and in the dollars saved, when compared with the base case, even with large variations in the target age group for vaccination, the proportion of case-patients seeking medical attention, and the cost of vaccine delivery. The technical feasibility of global eradication is supported by the availability of an easily administered, inexpensive vaccine (OPV), the epidemiological characteristics of poliomyelitis, and the successful experience in the Americas with elimination of wild poliovirus infection. This model demonstrates that the Poliomyelitis Eradication Initiative is economically justified.

Child, Preschool↗

PubMed1995

The relationship between cost-effectiveness analysis and cost-benefit analysis.

This paper examines the relationship between cost-effectiveness analysis and cost-benefit analysis. Provided that a cost-effectiveness analysis includes all the relevant societal costs, it is shown that a cost-effectiveness analysis can be interpreted as a cost-benefit analysis where the willingness to pay per effectiveness unit is assumed to be constant and the same for everyone. To relax this assumption the willingness to pay per effectiveness unit can be allowed to vary depending on for instance the size of the health effects and the target population. It is argued that cost-effectiveness analysis is best viewed as a subset of cost-benefit analysis, where the aim of the analysis is to estimate the cost function of producing health effects. It is also concluded that to interpret and use cost-effectiveness analysis as a tool to maximize the health effects for one specified real-world budget, will be inconsistent with a societal perspective and is likely to lead to major problems of suboptimization.

Cost-Benefit Analysis↗

PubMed1980

Alternative to mental hospital treatment. II. Economic benefit-cost analysis.

A cost-benefit analysis should be seen not as a mechanism for deciding mechanically on the allocation of funds and resources among programs but as a structure for weighing advantages and disadvantages (that is, for organizing knowledge). Considering all the forms of benefits and costs that we were able to derive in monetary terms, the experimental program provided both additional benefits and additional costs as compared with the conventional treatment. However, the added benefits, some +1,200 per patient per year, are nearly +400 more per patient per year than the added costs. A number of the forms of benefits and costs that we have measured in quantitative but nonmonetary terms show additional advantages of the community-based experimental program. The generalizability of a single experiment is limited, but the methodologies developed may be useful if their proper role is appreciated.

Adult↗

PubMed1988

Screening blood donors for human immunodeficiency virus antibody: cost-benefit analysis.

The costs and benefits of screening blood donors for antibody to human immunodeficiency virus (HIV) are assessed. Total costs, including testing, discarding processed blood, marginal donor recruiting, notifying and evaluating positive donors, are $36,234,000 annually for 10 million donors in 1986. Screening these donors will prevent 292 cases of transfusion-transmitted acquired immune deficiency syndrome (TT-AIDS), saving the costs of therapy and loss of earnings for total benefits of $43,490,480, a benefit:cost ratio of 1.2:1. Net economic benefits of $0.73 per donor will arise from the program. Calculated benefits will rise as increased numbers of infected recipients are diagnosed with longer follow-up or as partially effective therapy increases the cost of caring for patients with AIDS. Changes in test sensitivity, follow-up procedures, estimated value of life, and testing costs will also alter these projections, but none as dramatically as a change in the overall specificity of the screening process. The cost per case of TT-AIDS prevented, $124,089, and cost per year of life extended, $10,885, are comparable to costs of other screening programs.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Toward the incorporation of costs, cost-effectiveness analysis, and cost-benefit analysis into clinical research.

Most research in clinical psychology and related disciplines does not measure, report, or analyze costs, cost-effectiveness, or cost-benefit analysis. Reasons for this are discussed. It may be thought, for example, that costs are trivial to measure. Data are presented to show that the values of resources consumed in treatment (i.e., costs) actually can be quite complex to assess accurately and completely. Research findings are assembled to show that costs, as experienced by clients, may be beneficial to assess in that they can be significantly related to the outcomes of treatment. Empirical findings also show that costs also can be useful to measure because costs and outcomes can be related inversely rather than directly (i.e., clients may benefit most from treatments that cost less than several viable alternatives). Finally, perceived impediments to assessing costs and to cost-effectiveness and cost-benefit analysis in psychology are considered. Dialogue is encouraged on the scientific study of relationships between (a) monetary and other costs, (b) treatment techniques and treatment delivery systems, and (c) psychological and economic outcomes.

Costs and Cost Analysis↗

PubMed1976

Screening for spina bifida cystica. A cost-benefit analysis.

The costs and economic benefits are examined of introducing a programme for the mass-screening of pregnancies for the detection and abortion of fetuses with spina bifida cystica. A benefit-cost index is derived, and the possible effects on it of making different input assumptions are discussed. It is considered that, on economic grounds, screening may be worthwhile only in populations in which the incidence of spina bifida is high.

Amniocentesis↗

PubMed1989

Prevention of catheter-associated urinary tract infection: a cost-benefit analysis.

A cost-benefit analysis was used to assess four strategies to prevent catheter-associated urinary tract infections in an acute care setting. Routine use of catheters with sealed collection junctions, selective use of these catheters, and oral antibiotic prophylaxis all result in fewer deaths, fewer infections, and lower overall costs than not using any of these. Routine use of sealed junction catheters results in fewer infections and deaths than does selective use. When the cost of a nosocomial urinary tract infection is +500, routine use of sealed junction catheters is also less expensive than selective use in many circumstances. Oral antibiotic prophylaxis would result in the lowest net cost and the fewest deaths and infections, if it were as effective as parenteral prophylaxis, if more than 72% of patients received it, and if important negative factors such as selection of antimicrobial resistance and adverse drug reactions are not considered. When there is no extra cost of sealed junction catheters, their use is less expensive than the oral prophylaxis strategy if the total cost of oral prophylaxis, including the cost of adverse reactions, is greater than +15. If the extra cost of sealed junction catheters is +4 per unit, their use is less expensive than oral prophylaxis when its cost exceeds +35. Prevention of catheter-associated urinary tract infection reduces the overall cost of patient care, even when the prevention itself incurs costs. This analysis supports the routine use of sealed junction catheters in most acute care situations that require indwelling catheter drainage. Currently, we do not recommend routine antibiotic prophylaxis.

Catheters, Indwelling↗

PubMed1990

Cisplatin-based combination chemotherapy in the treatment of advanced-stage testicular cancer: cost-benefit analysis.

A cost-benefit analysis of the impact of cisplatin-based combination chemotherapy for treatment of disseminated testicular cancer showed that the annual estimated economic value of this treatment innovation in the United States is approximately $150 million. The estimate was based on the human capital approach, which conservatively values a human life in terms of economic productivity. Because testicular cancer predominantly strikes young adult males, the savings reported were due to the future earning potential of the survivors. A comparison of relevant National Cancer Institute (NCI) costs for drug development and clinical trials versus annual savings realized indicated that the total costs over a 17-year period are recovered in less than 1 year. This report is an example of health care cost savings resulting from NCI support of biomedical research.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

The value of multiple preparations in the diagnosis of malignant pleural effusions. A cost-benefit analysis.

A cost-benefit analysis of five techniques employed in processing 108 malignant pleural effusions for cytopathologic examination was performed. Ethanol-fixed, Papanicolaou-stained smears were positive in 68% of the effusions, air-dried Diff-Quik-stained smears in 66%, Cytospins in 83%, cell blocks in 85% and Millipore filters in 85%. Examination of one air-dried smear and one ethanol-fixed smear yielded a diagnostic sensitivity of 82%. Using a combination of two smears and one of three concentrating techniques (Cytospin, cell block or MIllipore filter) would have provided a diagnosis in over 90% of the effusions. The use of four or more preparations provided more sensitivity than did three preparations and decreased the likelihood that a malignant diagnosis would be based on the findings in only one preparation. The costs related to disposable materials and the College of American Pathologists (CAP) work load estimates for specimen preparation, staining and screening were compared. These data may be useful in developing optimal protocols for pleural effusion preparation in laboratories with specific work load requirements and limited resources.

Cost-Benefit Analysis↗

PubMed1990

[Mammographic screening for breast cancer--a cost-benefit analysis].

A cost-benefit analysis of the Swedish model for screening for neoplasma malignum mammae revealed scientific shortcomings in the basis for decision. It was not possible to determine whether the screening model involved a net loss or a net profit for the individual woman. Since false confidence seems to increase the mortality in breast cancer a new dimension was introduced, a sensitivity index as an expression of revealed fractions of the incidence in the participant population. This sensitivity index estimated some two thirds of the malignant neoplasms which are normally diagnosed in a two year period.

Breast Neoplasms↗

PubMed1976

Preventing the birth of infants with Down's syndrome: a cost-benefit analysis.

The costs and economical benefits of providing routine prenatal diagnosis of Down's syndrome with termination of affected pregnancies in older pregnant women in the west of Scotland were examined. The potential economic benefits would be greater than the costs for women aged 40 and over, probably about equal to costs for those aged 35 and over, but less than costs if the service were extended to women under 35.

Abortion, Therapeutic↗

PubMed1999

Life-cycle preferences over consumption and health: when is cost-effectiveness analysis equivalent to cost-benefit analysis?

This paper studies life-cycle preferences over consumption and health status. We show that cost-effectiveness analysis is consistent with cost-benefit analysis if the lifetime utility function is additive over time, multiplicative in the utility of consumption and the utility of health status, and if the utility of consumption is constant over time. We derive the conditions under which the lifetime utility function takes this form, both under expected utility theory and under rank-dependent utility theory, which is currently the most important nonexpected utility theory. If cost-effectiveness analysis is consistent with cost-benefit analysis, it is possible to derive tractable expressions for the willingness to pay for quality-adjusted life-years (QALYs). The willingness to pay for QALYs depends on wealth, remaining life expectancy, health status, and the possibilities for intertemporal substitution of consumption.

Attitude to Health↗