1 From the Julius Center for Health Sciences and Primary Care (E.B., P.J.N., T.B.v.d.W., Y.v.d.G.) and Depts of Radiology (W.P.T.M.M.), Neurology (L.J.K.), and Vascular Surgery (B.C.E.), Univ Medical Center Utrecht, Heidelberglaan 100, Rm D01.335, 3584 CX Utrecht, the Netherlands; Program for Assessment of Radiologic Technology, Dept of Epidemiology and Biostatistics, and Dept of Radiology, Era...

BACKGROUND Implementing organizations are pressured to be accountable for performance. Many health impact metrics present limitations for priority setting; they do not permit comparisons across different interventions or health areas. In response, Population Services International (PSI) adopted the disability-adjusted life year (DALY) averted as its bottom-line performance metric. While interna...

At present time, there is uncertainty regarding whether influenza-like illness in healthy adults is best managed by preventive efforts that use the trivalent influenza vaccine, administration of neuraminidase inhibitors at the onset of illness, or recommendation of supportive care alone at the onset of illness. We conducted a cost-effectiveness analysis that examined these 3 strategies for mana...

BACKGROUND In many countries, the incremental cost-effectiveness ratio (ICER) is used to assess whether an intervention is worth its costs. At the same time, policy makers often feel uncomfortable with refusing reimbursement of any intervention purely on the basis of the fact that the ICER exceeds a specific threshold value. Reluctance to define a single threshold value for the ICER seems to ha...

INTRODUCTION Patients who require prolonged mechanical ventilation (PMV) are increasing and producing financial burdens worldwide. This study determines the cost per QALY (quality-adjusted life year), out-of-pocket expenses, and lifetime costs for PMV patients stratified by underlying diseases and cognition levels. METHODS A nationwide sample of 50,481 patients with continual mechanical venti...

Historically, surgical outcomes have been measured by rates of mortality and morbidity. Fortunately, in plastic surgery, mortality is rarely an issue unless one is practicing in high-risk settings such as burn units or war zones. The improvement of presurgical morbidity, however, is very relevant to our specialty, and great effort should be made to measure it as precisely as possible. The succe...

BACKGROUND Patients diagnosed with irritable bowel syndrome may have coeliac disease. AIM To evaluate the cost-effectiveness of coeliac disease testing in suspected irritable bowel syndrome. METHODS We used decision analysis to estimate the number of coeliac disease cases detected, quality-adjusted life-years gained, and costs resulting from testing suspected irritable bowel syndrome patien...