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Health Outcomes, Cost-Benefit Analysis, Cost-Effectiveness
Health outcomes research typically uses cost-effectiveness or cost-utility analysis. These approaches take a narrow perspective of the individual effects, typically from the payer or the provider point-of-view. However, using these narrow perspectives misses macro-level, or societal level, benefits and costs that could significantly alter whether an intervention is considered beneficial or cost-effective. The societal perspective accounts for all the effects impacting patients, their families, the public, and government expenditures for a healthcare intervention. Such a perspective is vital for healthcare interventions for illnesses where morbidity and long absences from work are probable. A cost-benefit analysis would account for all the societal benefits and costs, allowing policy-makers to observe an outcomes analysis more closely reflective of the real impacts. This paper clearly presents why a societal perspective using cost-benefit analysis should be the preferred method of health outcomes research. An example of breast cancer interventions is used to illustrate this point.