title: Cost-effectiveness considerations in critical care.
abstract: The ICU, perhaps more than any other area in modern medicine, brings the conflicting issues of high cost and life-saving technology into stark relief. Cost-effectiveness analysis offers a quantitative method for selecting among treatments to optimize outcomes for any given financial outlay. Impediments to developing and using cost-effectiveness analysis to guide medical care decisions include the lack of accurate estimates or treatment effectiveness and reliable cost measures; variations in assumptions used in different cost-effectiveness analyses; and lack of an ethical or regulatory construct to ensure that the decisions will be carried out fairly. Recently, standards for performing cost-effectiveness analyses have been proposed which should enhance the quality and comparability of studies. A detailed understanding of the methods and limitations of economic analyses is essential to clinicians challenged by a growing number of articles and manufacturers' claims regarding the cost-effectiveness of critical care.
authors.affiliation: Department of Medicine, University of Washington, Seattle 98104-2499, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Rubenfeld
mesh_terms: D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics*; D003663:Decision Trees; D004470:Economics, Medical; D004992:Ethics, Medical; D006801:Humans