Clinical decision-making and the utilization of medical resources

A correspondence may be noted between the models used by clinicians for computer-aided diagnosis and the models required by social scientists to explain utilization of medical resources. Cost-benefit studies of a health facility require some assumption to be made in respect of utilization. The theory of individual decision-making under uncertainty may be used as a basis for the development of utilization models. Prior to this it is shown that decisions taken on one patient, and in particular the search for a diagnosis may all be explained. A marginal patient is defined and certain reasons for changes in the identity of the marginal patient are considered. Finally, some implications for the evaluation of policy changes in the N.H.S. are noted.