BOOKS OF RtfiDIfGS - PAHO/WHO

In#unrvlVolutn XV. September 1978
hysierectomy for olher than medical indications.
In addition lo thes financial considerations.
mortaliiy calculations-performed by ihe auihors-were
found lo be i, agreement with
those of Cole and Berlin. Our analysis showed
thal 30-year-old women undergoing elcclive
hysterectomy could expect an average increase
in life expectancy of 0.32 years. assuming
a 0.06"i operative monality. However.
half of those addilional years of life would be
lived after the age of 75. and 7?8f would be
lived after the age of 65. Thus. the piocedure
would largely benefit elderly women al the expense
of the young uaman who would no¡ survive
the surgery.
Whether a given woman should have a hys-
Iereciomy is an individual decision. Whether
eleclive hyslereclomies should he financed by
third panies is a policy decision which is more
likely io be at leas¡ partially influenced by direct
cosi considerations. If such a decision resulted
in an increase in the nel cost of care.
such costs would he borne by ihe public
Iwefm;c aid N«oM
- 399 -
through higher insurance premiums. If the decision
resulled in a decrease in the nel costs
of medical care. the public might be expected
to benefit through Jecreased premiums. The
findings of ihis study. and the companion analyses.
suggest that a policy of permilling eleclive
hyslerectomies probably would not be
cosi-beneficial when direct costs are considcred.
However. financial crileria are necessary.
though nol sufficienl. for making policy
decisions on a societal level.
Wilh the increasing cosls of medical services.
and the increasing role of government
and ihird parlies. limits probably will be sel
on ¡he amount of money the country will
spend on heallh services. and on ihe type, of
services ihat can be reimbursed. Cost-benefil
;tinalyses such as this can provide information
,ich is useful in making such decisions; even
so. many olher factors will need lo be considcred.
regardJless of whether the decision is
bcing made by an individual. an underwriter.
or the governmentl.
Mead. . S ríti.al OeWulrgnJ ém .O, .tSlu. I#ipiuh. sun J.I,,rnul e/ . t ,trJ .41t(' ¿97>t0 I)HFW. Public
Ilc4lth Serustc. S H li .R.sllc. Md 1975 Vol I.
S.e I ablc I-'5 pp 1-71
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