Costs and Benefits in Health Care and Prevention de U. Laaser

Costs and Benefits in Health Care and Prevention: An International Approach to Priorities in Medicine

U. Laaser

E. J. Rocella

J. B. Rosenfeld

H. Wenzel

One of the main purposes of medical cost-benefit analyses isto define the rational priorities in health care. This bookambitiously undertakes to compare the cost-benefit analysesof three countries: the United States, Germany and Israel.Cardiovascular disease is focused on to provide a model casestudy, but other areas also provide examples. The contribu-tions consider in particular two recent developments. Theseare the increase in comprehensive epidemiological data, es-pecially with regards to risk factors, and improved methodo-logy for measuring the quality of life. The contributionsstem from clinicians, epidemiologists and health economistswho give an overall picture of these complex issues and theprospects for the future.

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Cuprins

I Introduction.- Epidemiology and Economy, and the Appraisal of Human Life: Ethical and Practical Limitations of how to Value Health Benefits.- II Concepts.- Cost-Effectiveness Analysis, Cost-Benefit Analysis and the Value of Life in Health Care and Prevention.- Cost-Effectiveness Analysis in Health Care: Opportunities and Challenges to International Comparisons.- The Feasibility of Willingness-To-Pay Measurement in Health Services Research.- The Willingness-To-Pay Approach: Caveats to Biased Application.- III Experience.- 1. The Case of a Risk Factor: Hypertension.- Attitude and Behaviour of Stuttgart’s Primary Care Physicians with Regard to the Pharmacological and Non-Pharmacological Treatment of Mild Hypertension.- Comparisons of 1977 and 1987 Physician’s Knowledge Survey — Implications on Cost and Hypertension Management.- Evaluation of Cost-Effectiveness of Physician-Nurse Teams as Compared to Physicians Working alone in Primary Care Practices in Community Control of Hypertension.- The Ashkelon Hypertension Detection and Control Program: Medical and Cost Implications.- The Mangement of Hypertension: A Clinical Dilemma with Health Policy Implications.- 2. The Case of Clinical Disease.- Angina Pectoris Prophylaxis: A Model Estimate of Cost and Benefit.- Cost Considerations for the Management of End Stage Renal Disease in the United States.- Medical Treatment and its Implications on Costs. An Analysis with Process Data from the German Statutory Health Insurance.- IV The New Dimension: Quality of Life.- Quality of Life: Methodological Key Issues.- Towards the Integrated Measurement of Quality of Life.- Quality of Life, Clinical Trials, and Cost-Effectiveness Analysis: Conceptual Issues with Hypertension as an Example.- V Comments on the State of the Art.- Noteson Economic Evaluation.- Some Limitations in the Analysis of Costs and Benefits.- Research Perspectives for the Future: International Cooperation in Comparing Costs and Benefits of the Best Demonstrated Practice in Health Care and Prevention.