01.09.2016 | Research Methods and Statistical Analyses (Y Le Manach, Section Editor) | Ausgabe 3/2016
Health-Economic Researches in Perioperative Medicine
Current Anesthesiology Reports
- Paul Landais, Sihame Chkair, Thierry Chevallier, Mariella Lomma, Yannick Le Manach, Jean-Pierre Daurès
Purpose of Review
Since healthcare costs have continued to rise, health-economic approaches in perioperative medicine tend to create potential benefits. However, a review of the perioperative literature reveals that there are only few published economic analyses. The aim of the present review is to explore the health-economic researches in the field of perioperative medicine.
In perioperative medicine, cost-effectiveness is the most represented method of health-economic analysis. The recent CHEERS statement enables a critical appraisal of health-economic papers. Conducting systematic reviews of economic evaluations has been also reviewed. Costs and costing methods according to the type of approach retained, along with the three important steps in costing, have evolved. The costing principles and costing process, as well as the gross costing and microcosting approaches are becoming more detailed. Between the top-down and bottom-up approaches, several methods of measuring the costs have been proposed, considering the level of accuracy of the cost measurement. The “outside –In” approach, combining the two former approaches, has been newly introduced. The methods available to calculate the cost of an act either consider the accuracy in identifying the resources or the accuracy of valorizing the resources.
Important costs are attached to the perioperative period. Thus, a health-economic approach is particularly valuable in this context. Health-economic analysis provides tools to orient decision-making in order to better use the available resources. Anesthesiologists should seize the health-economic concepts and methods to better guide their medical decision and orient their policymaking in the domain of perioperative medicine.