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Cost Effectiveness in the Prevention of Suicide

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Manage or Perish?

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Abstract

In a preface to a symposium concerning economics, Professor Norman Sartorius1 stated: “At least three questions seem to beset the health care system of the world today a) How much money are we spending on health care, b) Could we get as much or more effect for less money and c) Who should be paying for health care.” As these three questions are so crucial in today’s world, it seems to be important to be able to justify the strategies we use in the health care system by means of realistic cost effective analysis. It is also important that we try to describe the costs and the benefits in a similar language so that comparisons can be made. It is e.g. not easy to compare the costs for the Selective Serotonin Reuptake Inhibitors (SSRIs) with the 3 point difference on the Hamilton Depression Scale (HAM-D) usually found between the SSRI group and the placebo group in studies where SSRIs are compared to placebo in 6-8 week long trials.2 However, the language of economics, borrowed from the economic sciences is not optimal when used in the health care setting. As pointed out by Professor Sartorius1 it is often difficult to decide which expenses concern health care. It is difficult to know whether an expense was related to treatment of disease, improvement of health or improvement of quality of life. Furthermore, at present there is little agreement about the minimum, optimum or (excessive) maximum of care necessary for a single patient. Another problem that arises is that of accounting for the amount of effort that patients themselves and their families invest. Finally, the ways of measuring the indirect costs of diseases are at present unsatisfactory and have met limited acceptance.

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Authors and Affiliations

  1. Department of Neuroscience Psychiatry, University Hospital Uppsala University, Uppsala, SE-751 85, Sweden

    Lars von Knorring M.D., Ph.D., Professor Kerstin Bingefors M.Sc., Ph.D. & Lisa Ekselius M.D., Ph.D.

  2. Department of Neuroscience Child and Adolescent Psychiatry, University Hospital Uppsala University, Uppsala, SE-750 17, Sweden

    Anne-Liis von Knorring M.D., Ph.D. & Professor Gunilla Olsson M.D., Ph.D.

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  1. Lars von Knorring M.D., Ph.D.
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  2. Professor Kerstin Bingefors M.Sc., Ph.D.
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  3. Lisa Ekselius M.D., Ph.D.
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  4. Anne-Liis von Knorring M.D., Ph.D.
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  5. Professor Gunilla Olsson M.D., Ph.D.
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Editors and Affiliations

  1. Department of Psychiatry, University of Geneva, Geneva, Switzerland

    José Guimón M.D. (Professor and Chairman) (Professor and Chairman)

  2. University of Geneva, Geneva, Switzerland

    Norman Sartorius M.D. (Professor of Psychiatry) (Professor of Psychiatry)

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von Knorring, L., Bingefors, K., Ekselius, L., von Knorring, AL., Olsson, G. (1999). Cost Effectiveness in the Prevention of Suicide. In: Guimón, J., Sartorius, N. (eds) Manage or Perish?. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4147-9_35

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  • DOI: https://doi.org/10.1007/978-1-4615-4147-9_35

  • Publisher Name: Springer, Boston, MA

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