BOOKS OF RtfiDIfGS - PAHO/WHO

WARNER AND HUTTON
pal orientations of physicians-have increased
much more rapidly than those with
a prevention theme; consistent with the
increasing emphasis on personal health
services. analyses oriented toward individual
practitioner decision making appear
lo be growing more rapidly tha. those with
an orientation toward social or organizational
decision malking; CEA, a more readily
comprehensible technique, has come to
dominate CBA.
Some of the recent trends seem likely to
ixprsist in the near fuiture, while others are
more prohlematic We expect continued
growth in the medical joumals' share of
the literature. through increasing interest in
CBA/CEA among nonphysician health
professionals might restriet such relative
growth in the physician-orienited literature.
In any case. we would anticipate intensification
of the trend tuward concern
with individual practitioner decision making
and increasing use of CEA relative to
CBA. The r" .'1 n diagiosi s ¡;id treatmi('nt
orien.it.is. . ;h..y' #)r IllI¡¡¡V nit ik' St1statined.
Interest in thie .t Il spl)e ifice
calpital-inteiisive inedical t'ehtu)logies
shotild prinmiote a diagRosis n¿d treatiment
ioctus, I)l!t the eIjerging, conven. COir healthl
proaoftimn atndl disease IprT.iviint.>in cill
re-verse the relative decvline iii ClBA/CEA
interest in prevention.
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n,.lIti-..ttrih,mmha misil>le tir delivering
health senrvices. By eonitrast. sul:perior
anjlyt'.s nmay achieve little impact .ss a const.llation
of tiactors-et)nomnie incentivei.s
politicatl concernas, etc.-itiay domiiiriate
('Inhi(lh'r¿ationls ,)f sl('itl ('(ost-efe('z'tix
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Actknowledrgment
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MWciCAL. CARE
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