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Health outcomes: a health economics perspective, CHERE Discussion Paper No 19

By Jane Hall and Alan Shiell


Interest in and a commitment to "outcomes" is growing. There is general agreement that "health outcomes" are a good idea but, as yet, no generally agreed concept of what health outcomes are about. This paper offers a conceptual framework for the discussion of health outcomes from the perspective of health economics. It is written for a non-economics audience. This framework helps clarify the conceptual basis for health outcomes and identifies an agenda for research and development. The economics perspective on health outcomes draws on the analogy of the production process to clarify the relationships between health inputs, processes, outputs and final health outcomes. Jargon is kept to a minimum and technical points are expanded in self contained notes. A simple model of the production of health is described and then developed to include health promotion and non-health activities which are, nevertheless, beneficial to health. Conceptualising health outcomes with the economic framework provides the clarity needed to promote health outcomes and improve the effectiveness of health services. Doing good in health care is no longer good enough; we need to do better. Health outcomes are about doing better. So too is health economics. By making objectives explicit, and by systematic comparison of the costs and effects or health outcome of alternative means of meeting these objectives, health economics provides the most useful perspective on health outcomes

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