Economics Notes: Measuring outcomes in economic evaluations

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. …