Using Cost-Effectiveness Analysis to Improve Health Care: Opportunities and Barriers

Hardcover | December 10, 2004

byPeter J. Neumann

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As health costs in the U.S. soar past $1.5 trillion, much evidence indicates that the nation does not get good value for its money. It is widely agreed that we could do better by using cost-effective analysis (CEA) to help determine which health care services are most worthwhile. Americanpolicy makers, however, have largely avoided using CEA, and researchers have devoted little attention to understanding why this is so. By considering the economic, social, legal, and ethical factors that contribute to the situation, and how they can be negotiated in the future, this book offers aunique perspective. It traces the roots of EA in health and medicine, describes its promise for rational resource allocation, and discusses the nature of the opposition to it, using Medicare and the Oregon health plans as examples. In exploring the disconnection between the promise of CEA and thepersistent failure of rational intentions, the book seeks to find common ground and practical solutions. It analyzes the prospects for change and presents a roadmap for getting there. It offers pragmatic advice for cost-effectiveness analysts, discussing ways in which they can better translatetheir research findings into the basis for action. The book also offers advice for policy makers and politicians, including lessons from Europe, Canada, and Australia, and underlines the need for leadership to establish the conditions for change.

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As health costs in the U.S. soar past $1.5 trillion, much evidence indicates that the nation does not get good value for its money. It is widely agreed that we could do better by using cost-effective analysis (CEA) to help determine which health care services are most worthwhile. Americanpolicy makers, however, have largely avoided u...

Peter J. Neumann is at Harvard School of Public Health.

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Format:HardcoverDimensions:224 pages, 6.1 × 9.21 × 0.91 inPublished:December 10, 2004Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0195171861

ISBN - 13:9780195171860

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Table of Contents

1. Introduction2. The Promise and Promotion of CEA3. Resistance to CEA in the United States4. Understanding the Resistance5. Legal, Political, and Ethical Concerns6. Lessons from Oregon7. Does Anyone in America Really use CEA?8. CEA Abroad9. Imagining a Future for CEA10. Advice for CEA11. Advice for Policy makers and Politicians

Editorial Reviews

"Neumann's book is a thorough and very readable insight into the possible reasons for the wariness of US public opinion towards the use of cost-effectiveness analysis (CEA) and its role in supporting resource allocation decisions in the healthcare systems in the USA...His book is a wellstructured and authoritative contribution which should be studied by researchers and policy makers alike."--Health Economics