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IntroductionEconomics provides a logical, internallyconsistent paradigm for motivating public health.decision making and evaluating the outcomesEconomics evaluation considers the value of thequantity of outcomes produced rather than.distributions of outcomes
Economics in public health is the study of howscarce resources are allocated and how to use itto achieve maximum benefit.In public health resources might be allocated toproduce public health supplies and equipmentsthat is used by nurses or services for clients likehome visits.Clients use resources when adopting or changinghealth behavior or using medical care treatment
Allocation of scarce resources :Individuals and organizations allocating scarceresources are making choices. Thus, economicsis fundamentally about the choices that are madeabout the production and consumption of goodsand services.Economic evaluation:There are several methods used in economicanalysis. Such asCost analysisCost-effectiveness analysisCost Benefit analysis
Cost analysis: It refers to any evaluation that uses thestructured collection of costs without regard toevaluating health benefits or outcomes.Costs are frequently categorized into directcosts, indirect costs and i ntangible costs.•Direct and indirect costs can besubcategorized into medical and nonmedicallyrelated costs.
Direct medical costsof the resources used specifically for the healthcare services or intervention being measured.These frequently include all medical services,diagnostics testing and treatment includingmedications•Direct non medical costs can includenecessary expenses that arent health carerelates. These costs may include patienttransportation costs.•Indirect costs attempt to measure theeconomic value of resources that are lost as aresult of contracting an illness or participating in
Commonly, indirect costs are measured as the value of lost wages or the value of lost leisure time.•Intangible costs attempt to quantify costs associated with the pain or suffering associated with disease or its treatment.Intangible costs are extremely difficult to measure and thus are rarely included in many economic analysis.
Cost – Effectiveness analysis• It compares the costs of intervention with benefits that result from that intervention. CEA aggregates all appropriate costs for one or more health care interventions and express them in terms of health outcomes in their natural ( non monetary ) unit.• CEA is similar to cost benefit analysis except that it is not accepted that outcomes will be valued in monetary terms.• Results of CEA are commonly reported as two types of ratios, the average cost-effectiveness
appropriate measure when there are nocomparisons between interventions, and the ratiobecomes a simple description of the cost peroutcome for a single intervention or treatment.ICER used in the situation where two or moreinterventions are being compared. Forexample:Comparing two interventions (A and B) assumingintervention B is more expensive, the ICER forthis comparison can be expressed as:ICER= Total cost (B) – Total cost (A) Health outcome (B) – Health outcome
•CEA results present decision makers withquantifiable trade-offs between costs and theheath effects of the intervention being compared.•This technique can be used for final healthoutcomes (e.g., patients survived or Lives saved).And can also be used for intermediate outcome(e.g., number of patients quit smoking)• Intermediate health outcomes should be linkedto final health outcomes to be most useful (e.g.,measuring patients who quit smoking can bedirectly linked to lung cancer cases prevented).)
Cost - Benefit Analysis• CBA compare the costs of an intervention with dollar value of benefits.• CBA is an economic analysis in which both the costs and health outcomes are expressed in terms of a net benefit representing the difference between all input ( costs) and all outcomes ( both positive and negative health consequences).
•These analyses are designed to place amonetary value on all resources being used in anintervention or to implement a policy. They alsoplace a dollar value on all outcomes of anintervention or policy change. In health care,sometimes these analyses are disliked becausethey require time preferences for health statusand attempt to place dollar value on life•CBA often used in environmental health, It alsocan be used to evaluate policy changes,community level interventions or individual