HEALTH-CARE CBA CEA - AN UPDATE ON THE GROWTH AND COMPOSITION OF THE LITERATURE

Cost-benefit (CBA) and cost-effectiveness analyses (CEA) are methods t hat enumerate the costs and consequences associated with health-relate d technologies, services, and programs. This article examines the tren ds in published CBA and CEA of personal health services from 1979 thro ugh 1990. It is based on a bibliography that was compiled to help addr ess the immense need for information on the variation and effectivenes s of medical practices, particularly as researchers expand their analy sis to a study of the cost effectiveness of medical and surgical inter ventions, health care technologies, preventive practices, and other he alth programs. A systematic search was conducted for all articles unde r the heading ''cost-benefit analysis'' (which includes cost-effective ness analysis) and ''costs and cost analysis.'' Data sources included the MEDLARS (National Library of Medicine) database, other bibliograph ies in specialized areas, reference lists in key articles, and contact s with researchers in the field. All titles and abstracts were scanned to determine if the articles pertained to personal health services an d if both costs and consequences were assessed. If both criteria were met, the article was included in the bibliography. This search resulte d in 3,206 eligible CBA/CEA publications from 1979 through 1990. The p ublications were subdivided into two major categories: reports of stud ies and ''other'' publications, including reviews, descriptions of met hodology, letters, and editorials. Reports of studies and ''other'' pu blications were classified into approximately 250 different topic area s. The studies were further classified by parameters, such as study ty pe, publication vehicle, and medical function. This article describes the results of this classification and describes trends during 1979 to 1990 compared with 1966 to 1978. The classification of study reports and ''other'' publications into 250 topic areas is presented in Append ix A. The entire bibliography is reproduced in Appendix B. Detailed ta bles of findings are presented in Appendix C, and the results are illu strated graphically in Appendix D. Appendix E provides the coding sche me used in the bibliography's data base.