title: The complex interface between economy and healthcare: An introductory overview for clinicians.
abstract: In a period of generalized economic crisis, it seems particularly appropriate to try to manage a continuing growing sector such as healthcare in the best possible way. The crucial aim of optimization of available healthcare resources is obtaining the maximum possible benefit with the minimum expenditure. This has important social implications, whether individual citizens or tax-funded national health services eventually have to pay the bill. The keyword here is efficiency, which means either, maximizing the benefit from a fixed sum of money, or minimizing the resources required for a defined benefit. In order to achieve these objectives, economic evaluation is a helpful tool. Five different types of economic evaluation exist in the health-care field: cost-minimization, cost-benefit, cost-consequences, cost-effectiveness and cost-utility analysis. The objective of this narrative review is to provide an overview of the principal methods used for economic evaluation in healthcare. Economic evaluation represents a starting point for the allocation of resources, the decision of the valuable investments and the division of budgets across different health programs. Moreover, economic evaluation allows the comparison of different procedures in terms of quality of life and life expectancy, bearing in mind that cost-effectiveness is only one of multiple facets in the decision making-process. Economic evaluation is important to critically evaluate clinical interventions and ensure that we are implementing the most cost-effective management protocols. Clinicians are called to fulfill the complex task of optimizing the use of resources, and, at the same time, improving the quality of healthcare assistance.
authors: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Italy. Electronic address: federica_ottolini@libero.it.
authors: Federica Liliana
authors: FL
authors: Ottolini
authors: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Italy. Electronic address: buggiolaura@gmail.com.
authors: Laura
authors: L
authors: Buggio
authors: Fondazione Ca' Granda Ospedale Maggiore Policlinico Via Commenda, 12-20122 Milano, Italy. Electronic address: dadosomigliana@yahoo.it.
authors: Edgardo
authors: E
authors: Somigliana
authors: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Italy; Fondazione Ca' Granda Ospedale Maggiore Policlinico Via Commenda, 12-20122 Milano, Italy. Electronic address: paolo.vercellini@unimi.it.
authors: Paolo
authors: P
authors: Vercellini
mesh_terms: D003362:Cost-Benefit Analysis; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics*; D004470:Economics, Medical; D006801:Humans; D020380:Needs Assessment; D057240:Patient Preference; D011788:Quality of Life; D019057:Quality-Adjusted Life Years
keywords: Cost-effectiveness analysis; Cost-utility analysis; Economic evaluation; Efficiency; Healthcare spending