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The Journal of Bone and Joint Surgery 81:142-143 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Kevin B. Freedman, M.D., Stephen S. Raab, M. D., Daniel D. Slagel, M.D. and Robert A. Robinson, M.D., Ph.D.

TO THE EDITOR:

In "The Utility of Histological Examination of Tissue Removed during Elective Joint Replacement. A Preliminary Assessment" (80-A: 331–335, March 1998), by Raab et al., the authors referred to their study as both a cost-effectiveness analysis (p. 331) and a cost-benefit analysis (p. 335). However, this study is neither a cost-effectiveness analysis nor a cost-benefit analysis; it is a cost-identification study. This distinction is important.

There are three different types of economic analyses: cost-identification, cost-effectiveness, and cost-benefit3. One uses cost-identification analysis to estimate the cost of an intervention but not its benefit. A cost-effectiveness analysis has a broader perspective in that it incorporates both cost and effect. The cost and the outcome (or benefit), however, are not expressed in the same units. For example, the cost is expressed in dollars and the outcome is expressed in years of life gained (quality-adjusted life-years). The results of this type . . . [Full Text of this Article]


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