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Cost-Effectiveness Analysis for Urban Health Research

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Handbook of Urban Health

10.0. Conclusion

Cost effectiveness analysis is the principal method for examining the efficiency of health interventions, with both widespread acceptance and official sanction from a number of governmental agencies. Although some have criticized such analyses as a means on which to base decisions, three important caveats to the use of CEA are necessary. First, such analyses are models that attempt to estimate efficiency, but the application of such analyses should always question the models assumptions to ascertain if they are applicable in a particular urban setting. Second, users and analysts of CEA should carefully assess the uncertainty in the analysis. Too often, the base case analysis receives the bulk of attention in an attempt to classify an intervention as “cost effective” or not. Appropriate attention to the assessment of uncertainty is important for identifying questions that are important for making better decisions. Finally, CEA — even if accepted as a good measure of efficiency — is only one attribute that decision makers should consider when making resource allocation decisions. CEA can be an important input to such decisions, but so are considerations of politics, law, ethics and justice. Resource allocation decisions will remain complicated without simple technical solutions.

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  1. Center for Research on Inner City Health, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada

    Ahmed M. Bayoumi

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  1. Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York

    Sandro Galea  & David Vlahov  & 

  2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York

    Sandro Galea  & David Vlahov  & 

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Bayoumi, A.M. (2005). Cost-Effectiveness Analysis for Urban Health Research. In: Galea, S., Vlahov, D. (eds) Handbook of Urban Health. Springer, Boston, MA . https://doi.org/10.1007/0-387-25822-1_21

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