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Decision Analysis: Balancing Quality and Cost

Published online by Cambridge University Press:  02 January 2015

Karen J. Brasel*
Affiliation:
Department of Surgery, St Paul-Ramsey Medical Center, St Paul, Minnesota
John A. Weigelt
Affiliation:
Department of Surgery, St Paul-Ramsey Medical Center, St Paul, Minnesota
*
St Paul-Ramsey Medical Center, 640 Jackson St, St Paul, MN 55101-2595

Abstract

Healthcare reform is a topic consuming the time and energy of many healthcare professionals, administrators, and politicians. One goal of reform is to improve value—better quality health care for less cost. Unfortunately, much of the current debate proceeds without clear definitions of quality or cost. To have profitable discussion, we must have precise definitions. With these definitions in hand, the technique of decision analysis provides a unique opportunity to evaluate quality and costs of healthcare decisions simultaneously. We believe it is imperative for physicians to become familiar with this important and powerful tool.

Type
Issues in Surgery
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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References

1. Gill, TM, Feinstein, AR. A critical appraisal of the quality of quality-of-life measurements. JAMA 1994;272:619626.CrossRefGoogle ScholarPubMed
2. Bergner, M, Bobbitt, RA, Carter, WB, Gilson, BS. The sickness impact profile: development and final revision of a health status measure. Med Care 1981;19:787805.CrossRefGoogle ScholarPubMed
3. Ware, JE, Sherbourne, CD. The MOS 36-item short-form health survey (SF-36), I: conceptual framework and item selection. Med Care 1992;30:473483.CrossRefGoogle ScholarPubMed
4. Kaplan, RM, Anderson, JP. A general health policy model: update and applications. Health Serv Res 1988;23:203235.Google Scholar
5. Jennett, B, Snoek, J, Bond, MR, et al. Disability after severe head injury: observations on use of Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry 1981;44:285293.CrossRefGoogle ScholarPubMed
6. Keith, RA, Granger, CV, Hamilton, BB, Sherwin, FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehab 1987;1:618.Google Scholar
7. Finkler, SA. The distinction between cost and charges. Ann Intern Med 1982;96:102109.CrossRefGoogle ScholarPubMed
8. Pauker, SG, Kassirer, JP. Decision analysis. N Engl J Med 1987;316:250258.Google Scholar
9. Drummond, MF, Stoddart, GL, Torrance, GW. Methods for the Economic Evaluation of Health Care Programmes. Oxford, England: Oxford University Press; 1993.Google Scholar
10. Katz, DA, Cronenwett, JL. The cost-effectiveness of early surgery versus watchful waiting in the management of small abdominal aortic aneurysms. J Vasc Surg 1994;19:980991.CrossRefGoogle ScholarPubMed
11. Weinstein, MC, Stason, WB. Cost-effectiveness of coronary artery bypass surgery. Circulation 1992;66(suppl III):5665.Google Scholar
12. Etchason, J, Petz, L, Keeler, E, et al. The cost-effectiveness of preoperative autologous blood donations. N Engl J Med 1995;332:1924.Google Scholar
13. Fahs, MC, Mandelblatt, J, Schechter, C, Muller, C. Cost-effectiveness of cervical cancer screening for the elderly. Ann Intern Med 1992;117:520527.CrossRefGoogle ScholarPubMed