Rationalizing to avoid rationing. Techniques for the evaluation of healthcare economics

Introduction: one of the main problems of the healthcare systems of industrialized countries regards the allocation of resources needed for the prevention and treatment of the population's pathologies. Within the next decade, this phenomenon will gain importance for healthcare decision-makers given the continuous aging of the population and lengthening of life-expectancy of patients with the rapid development of technology. Aims: to assess healthcare economics through analysis of alternative intervention plans, based on efficiency standards to support decision-making procedures. Given the limited resources, the consequence in certain healthcare activities implies the impossibility of using the same resources in other productive and beneficial activities. The adoption of specific economic evaluation tools will enhance a sound usage of resources and avoid wastefulness and the consequenial indiscriminate budget cuts. Materials and methods: the report describes the objectives and procedures for the application of the main economic evaluation techniques in the Healthcare sector, with examples taken from the nurses' work environment: - Cost analysis, - Cost-effectiveness analysis, - Cost-benefit analysis, - Cost-utility analysis. Results: each technique opens out to valid options in matters of healthcare economic investments, though with different difficulty levels in determining the best investment. The decision-maker is assigned the task of choosing the instrument to be adopted according to the specific sectors, data and time available. Conclusions: the use of healthcare economic strategies implies the selection of health priorities and the implementation of strategies that can make these decisions operational. The criteria defining priorities depend on the culture, historical setting, preferences of the population and unfortunately, also political consent. The standards are not always made known, nor are they always easy to comprehend or accept, but nurses cannot exempt themselves from knowing at least the basic theories, especially if they cover managerial roles.