A brief description of the methods of economic appraisal and the valuation of health states

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Abstract
The interest of nurses in methods of economic evaluation appears limited to cost-effectiveness analysis, with an apparent unawareness of other methods of economic appraisal and the types of efficiency they consider. The main methods of economic appraisal are discussed, and linked to different kinds of efficiency. Methods for the valuation of health states, an important accompaniment to the methods of economic appraisal, are briefly described along with some of the practical difficulties. If skilled nursing care--alone or with other disciplines--changes health status then the measurement and valuation of such states may be used to inform resource allocation decisions involving nursing. It could be argued that the main impact of nursing is on quality of life, and if so this suggests cost utility analysis, and not cost-effectiveness analysis, as the natural level of appraisal for nursing. The use of these methods in research, and participation in their future development, are both suggested as valid targets for nurses to aim for.