Health Economics and Surgical Care

Abstract

Health care resources are scarce and yet the demand for them continues to grow. It is inevitable, therefore, that decisions must be taken about how best to deploy resources within the health care sector. The health economist argues that choices between competing health care interventions should be made on the grounds of economic efficiency or cost-effectiveness, i.e. we should choose those interventions which produce the greatest health benefit from the finite resources available. To facilitate such decision-making, it is necessary to have information on both the resource use inputs (or costs) and the benefits (or health outcomes) associated with the health care interventions we wish to choose between. Economic evaluation (which is becoming increasingly common in the health care setting) provides a vehicle for obtaining and synthesising this information. Surgery is constantly evolving. In the face of scarce resources, new technologies should be subject to cost-effectiveness considerations. Economic evaluation has been used to evaluate many surgical interventions, including: • percutaneous transluminal coronary angioplasty • coronary artery bypass grafting • transmyocardial laser revascularization • alternative surgical techniques for the repair of groin hernia • heart, kidney and liver transplantation.