Cost-effectiveness Analysis Appraisal and Application: An Emergency Medicine Perspective

Area of Science:

• Health Services Research
• Health Economics
• Emergency Medicine

Background:

• Cost-effectiveness analysis (CEA) is crucial for optimizing healthcare resource utilization in emergency departments (EDs).
• Limited formal training in CEA methodology exists among emergency medicine leaders and policymakers.
• ED decisions significantly impact healthcare resource utilization.

Observation:

• This paper introduces CEA interpretation and application specifically for emergency medicine.
• A hypothetical case of chest pain risk stratification in the ED is used to illustrate CEA.
• A widely cited checklist aids in appraising CEA, covering cost/outcome measurement, incremental, and sensitivity analyses.

Findings:

• The paper emphasizes good CEA practices, aligning with U.S. Panel on Cost-Effectiveness in Health and Medicine guidelines.
• Unique challenges for ED-based CEAs include projecting long-term outcomes, costing ED services, and generalizability.
• Limitations of CEA, such as excluding non-cost factors like ethics, are discussed.

Implications:

• Emergency medicine leaders and researchers will gain enhanced understanding of CEA critical appraisal and application.
• This work aims to improve resource allocation decisions in emergency care settings.
• Resources for conducting ED-based economic evaluation studies are provided.