Education And Debate Economics Notes

Measuring outcomes in economic evaluations

BMJ 1999; 318 doi: http://dx.doi.org/10.1136/bmj.318.7195.1413 (Published 22 May 1999) Cite this as: BMJ 1999;318:1413
  1. David Torgerson, research fellowa,
  2. James Raftery, professorb
  1. a National Primary Care Research and Development Centre, Centre for Health Economics, University of York, York YO1 5DD
  2. b Health Economics Facility, Health Services Management Centre, University of Birmingham, Birmingham B15 2RT
  1. Correspondence to D Torgerson

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

    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. …

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