Cost-benefit studies of health care programs. Choosing methods for desired results.
This article summarizes the results of a critical review of several cost-benefit analyses (CBA) of health care programs. With pertinent examples, it is demonstrated that the results and conclusions of a study depend upon the assumptions and methods underlying the measurement of costs and benefits in a CBA. Given the incentives for an analyst to comply with desires of his sponsor, and given the scope of the choice available to an analyst among alternative assumptions and methods, it seems quite possible that desired results often dictate the assumptions and methods chosen. It is recommended that a policy maker should suspect an advocacy in the results and conclusions of every CBA. If CBAs are to be a true decision aid, a policy maker ought to obtain several of them, each of which assesses the costs and benefits of a given action plan using assumptions and methods substantially different from the other.
D003362:Cost-Benefit Analysis / Q000379:methods*; D009313:National Health Programs / Q000191:economics*; D011050:Policy Making; D014481:United States