Title: Economic evaluation and clinical decision-making: how many birds can one kill with one stone?

Authors: Amiram Gafni

Addresses: Centre for Health Economics and Policy Analysis, Department of Clinical, Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada

Abstract: This paper explores whether one can utilise the same approach for the measurement of outcome for both tasks of clinical decision-making and programme evaluation (i.e., economic evaluation in this paper). We explain why, in spite of the assumed similarity, the two tasks are different with respect to what is needed to be measured as an outcome. This makes the task of finding one measure that will enable us to ||kill two birds with one stone|| very difficult. We suggest a practical solution to the problem which is the use of the decision board instrument to find out patients| preferences for treatment (which is the outcome required for the clinical decision-making process). We can also use a modified version of the decision board to measure individuals| willingness-to-pay for services (which is the outcome required for an economic evaluation when one utilises the cost-benefit analysis approach). The paper describes the practical experience to date with this approach and argues that it is feasible.

Keywords: economic evaluation; willingness to pay; clinical decision-making; decision aids.

DOI: 10.1504/IJHTM.2000.001072

International Journal of Healthcare Technology and Management, 2000 Vol.2 No.1/2/3/4, pp.71-85

Published online: 30 Jun 2003 *

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