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[Introduction to methods of economic modelling: a primer for orthopaedic surgeons and traumatologists]
1Department of Orthopedic Surgery, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA. patrick.vavken@childrens.harvard.edu
Aim:
Health economics and cost-efficiency are ubiquitously present issues in present day orthopaedic surgery. These subjects, however, are almost exclusively dealt with by economists and policy makers, while medical professionals rarely take part, quite often because of insufficient methodological knowledge. This report presents the basics of economic evaluation to orthopaedic surgeons to facilitate informed discussion.
Method:
This text reviews the basic methodology of economic evaluation and pertinent findings for orthopaedic surgery.
Results:
Economic evaluation combines costs and consequences of medical treatments. Partial analyses study costs only, while complete studies include different parameters of consequence. Cost-effectiveness analysis sets cost and effectiveness in natural metrics in relation, while cost-utility analyses present consequences as quality-adjusted life years. Cost-benefit analyses translate both costs and consequences into money value and thus produce a net benefit. Orthopaedic research focuses mainly on cost-utility analyses, yet their number and quality, despite both have been rising over the last years, are mostly insufficient to come to unequivocal conclusions or to produce clear recommendations.
Conclusion:
The trend for an increasing demand for economic evaluations in orthopaedic surgery will continue unabated. Both patients and medical professionals would benefit if orthopaedic surgeons received instruction in economic evaluations in order to be able to take part in such studies or to meaningfully discuss such matters.
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