How to use the results of an economic evaluation

BACKGROUND: Given the high costs of delivering care to critically ill patients, practitioners and policymakers are beginning to scrutinize the costs and outcomes associated with intensive care. Health economics is a discipline concerned with determining the best way of using resources to maximize the health of the community. This involves addressing questions such as which procedure, test, therapy, or program should be provided, and to whom, given available resources. PURPOSE: The purpose of this article is to review general economic principles that will help intensivists to better interpret published economic evaluations. DATA SOURCES: Selected articles from the health economics and critical care literature. RESULTS: In this article, we use an economic evaluation that examines sedation strategies in critically ill patients. We discuss how learning to critically appraise an economic evaluation is only part of the task for end users. Determining whether and how to apply the results of economic evaluations to local settings presents bigger challenges and remains largely a matter of judgment. CONCLUSIONS: Economic evaluations use analytic techniques to systematically consider all possible costs and consequences of clinical actions. Although they should never form the sole basis for clinical decisions for individual patients, economic evaluations offer potentially useful information at different levels of decision-making.