Cost-effectiveness analysis and emergency medical services for children: issues and applications.
Studies to assess the cost-effectiveness of alternative treatment or prevention strategies for children are far fewer than those for adults. This article highlights specific issues relevant to the conduct of cost-effectiveness analysis (CEA) in pediatric populations following the recommendations of the US Panel on Cost-effectiveness in Health and Medicine and discusses CEA applications relevant to emergency medical services for children. The article addresses whether patient time should be included in measures of costs, whether caregiver time costs are included and measured properly, and most importantly, whether the study can use quality adjusted life years (QALYs) as an outcome measure. Pediatric researchers may be unable to follow the panel's recommendations for including QALYs as an outcome measure in CEA studies involving young children. Developing preference weights applicable to young children may be a productive field for pediatric researchers. Without such efforts, the field of child health services research in general and the field of emergency medical services for children in particular will continue to lag behind adult fields in assessing the costs and outcomes of the services they provide.
Tilford
John M
JM
University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Center for Applied Research and Evaluation, Little Rock 72202-3591, USA. tilfordmickj@uams.edu
D002648:Child; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital / Q000191:economics*; D006302:Health Services Research; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010372:Pediatrics / Q000191:economics*; D019057:Quality-Adjusted Life Years