9 Economic evaluation in obstetrics and gynaecology

It is an economic fact of life in all health-care systems that decisions will have to be taken about which programmes and interventions should and should not be provided. The splitting of the roles of purchasing and providing within the UK's NHS has made these decisions more explicit and, together with devolved budgets, required more health service professionals to understand the analytical methods of economic evaluation. Certainly, increasing numbers of economic studies will be undertaken in obstetrics and gynaecology. Checklists exist to assist decision-makers in judging the quality of published studies (Drummond et al, 1987), but it should be emphasized that different studies seek to answer different questions. In particular, it is important to be aware of the level of efficiency being addressed in an analysis.