Economic analysis in hand surgery

Economic analysis is a method for allocating resources among competing alternatives. Four techniques commonly used in an economic analysis are cost-minimization analysis, cost-effectiveness analysis, cost-benefit analysis, and cost-utility analysis. These analyses provide information to guide medical decisions and to set funding priorities. Understanding the differences between the techniques allows for better decision making. Although economic analysis is used widely in other fields of medicine, its use in studies of disorders of the hand has been sparse. Only recently has economic analysis been included in studies focused on the care of the upper-extremity patient. As such, to interpret the results of these studies better, hand surgeons need to understand the similarities and differences and the strengths and weaknesses of the different techniques. Such an understanding will allow hand surgeons to know when economic analyses are comparable. Furthermore it will aid them in providing their patients not only medically sound care, but also economically efficient care. This article provides a synopsis of the most widely used and accepted techniques for performing an economic analysis. The key concepts of each of the 4 techniques are shown by using the small number of studies that are available in the upper-extremity literature.