The Concept of Clinical Economics and its Relation with Effectiveness

To provide an example we start with the perspectives. From a patient’s perspective, the alternative ways of action may be either immediate surgery or watchful waiting if there is a realistic chance of spontaneous regression. The costs for the patients will be an increased risk of complications in case of watchful waiting. The consequence (advantage for the patients) in this situation is the chance to avoid surgery. The perspective of the hospital manager will be different. He will also consider costs and consequences, but of different types, such as monetary costs and monetary consequences. Doctors and managers of a hospital have to do different jobs and to make different decisions. In some places the same person is responsible for both decisions. This is like somebody who is playing chess against himself.