Abstract
Cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA) are used increasingly in both clinical trials of health and human services, and in evaluations of programs to determine their future funding. Definitions of CBA and CEA are given and contrasted with each other and with requests for ‘cost analyses’ and ‘efficiency’ studies. The emerging importance of cost-utility analysis is noted as well. Emerging directions in cost-inclusive assessment are noted, including evaluating costs of using different services to add Quality-Adjusted Life Years and Disability-Adjusted Life Years – nonmonetary measures that can be almost as useful for comparing outcomes of diverse programs as monetary measures, i.e., program benefits. Advantages of conceptualizing ‘costs’ more broadly as the value of the specific types and amounts of resources used to provide services are explained. Ethical problems in cost-inclusive evaluation are highlighted, and possible solutions suggested. Viewing CBA and CEA as crucial parts of improvement-oriented operations research is recommended. Links for manuals and Web sites for cost-inclusive evaluation in health and human services are provided.
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