Cost-effectiveness analysis as an aid to decision making has been increasingly publicized and discussed during the past two to three decades. However, the total body of cost-effectiveness analyses in health care is actually rather small, and high-quality studies are rather rare. Furthermore, the applications of economic analysis to health policy have been hampered by a number of problems, including those that are methodological and contextual. We consider a number of areas of public health policy but pay special attention to a growing area of inquiry and application: the overall coverage of health services. Cost-effectiveness analysis has played a relatively small role in general coverage decisions, but in recent years, it has been applied increasingly to decisions concerning pharmaceutical coverage. We speculate on concerning reasons for this particular focus in cost-effectiveness analysis. Future progress will depend heavily on discussion and consensus building.

中文翻译：

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公共卫生服务和成本效益分析。

在过去的两到三十年中，成本效益分析作为决策的辅助手段越来越多地被公开和讨论。但是，医疗保健中成本效益分析的整体实际上很小，而高质量的研究却很少。此外，经济分析在卫生政策中的应用受到许多问题的阻碍，其中包括方法论和背景问题。我们考虑了公共卫生政策的多个领域，但特别关注了不断增长的查询和应用领域：卫生服务的总体覆盖范围。成本效益分析在总体承保决策中的作用相对较小，但近年来，它已越来越多地应用于有关药物承保的决策。我们推测出在成本效益分析中特别关注的原因。未来的进展将在很大程度上取决于讨论和建立共识。