Economic evaluation in health care: The point of view of informed physicians

Objectives: We investigated health professionals with a solid background in health-care management and economics to get their opinion and attitude on the use of economic evaluation at the policy, organizational, and professional levels of decision-making. Methods: A 12-item questionnaire was sent to 374 Italian health-care professionals who received training in economic evaluation of health-care programs in the last 10 years at the Bocconi School of Management, Milan, Italy. Results: The response rate was 46.8% (175 questionnaires). All respondents stated that the basics of economic evaluation analysis must be part of the overall knowledge of health-care professionals. The usefulness of economic evaluation for professional activities was rated 3.83 (scale 1-5). Respondents stated that economic evaluation is used more for managerial decisions than for clinical ones (mean 2.89 vs. 2.74, P = 0.09). "Decisions are taken according to a short-term perspective" was the most frequently reported barrier for the actual use of economic evaluation studies, particularly by managers (76.7%). "More training in health economics" was indicated as the incentive to expand its use by the majority of both clinicians and managers (64.6%). Significantly more managers than clinicians (74.4% vs. 54.1%, P = 0.005) considered that the maximum benefits of economic evaluation are reaped at organizational level. Conclusions: Informed Italian health professionals have a positive attitude toward the principles and the techniques of economic evaluation. They show appreciation of their potential role and report making some use of them in actual decision making.