Discussion of Paper by Wagner

Abstract

The paper under discussion is an attempt to offer to health planners a method of reaching decisions related to numbers, types, location, and time of investment for CT scanners, needed in an area (or state) in order to provide adequate medical care to the population with a minimum possible investment. In her approach to this subject Wagner has examined the following four points:

• 1. The layout of the information requirement for the investment in CT scanners

• 2. A review of existing data on economic evaluations of CT scanners, looking in particular at studies that can answer:

• a) How many

• b) What types (head or whole-body, or both)

• c) Where (possible locations)

• d) When — the timing of investment

• 3. A summarized presentation of the conceptual, methodological, or data limitations that interfere with useful macroeconomic evaluation of CT scanners

• 4. A suggested methodology for evaluation of the economic impact of alternative investment strategies for CT scanners that will bypass the limitations mentioned under point 3; the method proposed is based on the analytic technology of multi-objective programming