Cost-effectiveness analysis, cost-benefit analysis, and beyond: Evolving models for the scientist-manager-practitioner.

Models are described for measuring cost-effectiveness and cost-benefit in clinical research and for optimizing cost-effectiveness and cost-benefit in clinical practice. Three applications are provided of a model advocated by the author, cost procedure process outcome analysis. Traditional research often examines the degree to which treatment procedures are implemented and the extent to which those procedures affect biopsycho-social processes that may yield outcomes (procedure process outcome analysis). To these analyses we can add data on treatment costs for a complete model, that is, cost procedure -* process -* outcome. This model can be analyzed to find the least expensive way to achieve goal outcomes or the most effective way to deliver services within budget constraints.