BMJ 1999;318:1413-1413 ( 22 May )

Education and debate

Economics Notes

Measuring outcomes in economic evaluations

This is the fifth in a series of occasional notes on economics

David Torgerson, research fellow ^a,  James Raftery, professor ^b. 

^a National Primary Care Research and Development Centre, Centre for Health Economics, University of York, York YO1 5DD, ^b Health Economics Facility, Health Services Management Centre, University of Birmingham, Birmingham B15 2RT

Correspondence to D Torgerson

The first 150 words of the full text of this article appear below.

To make judgments about efficiency economic evaluation of health care has to compare health outcomes, however measured, with costs. Three main approaches exist to measuring outcomes: clinical end points, quality of life measures, and willingness to pay.

The simplest outcome measure to use in a trial is a clinical one, such as a reduction in the number of strokes or changes in blood pressure. Health economists use such measures to construct cost effectiveness ratios.¹ For example, in a trial aimed at preventing hip fractures a cost effectiveness ratio might be cost per averted hip fracture.

Measuring outcome in terms of clinical endpoints has the disadvantage that comparisons between different healthcare treatments are difficult. This is only partly solved when trial endpoints include mortality. Although estimates of cost per life gained or life year gained allow comparisons between very different therapies, using survival as an outcome measure for an economic evaluation . . . [Full text of this article]

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