Can health economics and the practical realities of delivering healthcare work side by side? Michel Wensing, professor of implementation science at Radboud University Medical Centre, Nijmegen, Netherlands, and co-editor-in-chief of实施科学considers a neweditorialon this question.

Many health professionals and health researchers have little interest in the costs of healthcare, perhaps with the exception of their personal reimbursement. Published economic studies have little relevance for them.

And, in fact, they may be correct. Economic analyses in healthcare are often designed to support decision-making on the reimbursement of treatments, devices and programs in national healthcare systems. Therefore a societal perspective and long-term time horizon are taken, non-healthcare costs are included, and non-clinical utilities are preferred as outcomes. Such economic studies have indeed little relevance for many decisions and practices in daily healthcare practice, management, or policy.

尽管如此，我认为健康经济学和健康技术评估提供了有趣的概念和方法工具箱。这些对于实施科学很有用，尤其是在具有一些灵活性和想象力的情况下使用。

即时通讯plementation of evidence-based recommendations and clinical outcomes are often perceived as more relevant than utilities (global values attached to health states), which are the preferred outcomes in health economics. In addition, it is often informative for decision-makers to provide an economic analysis that focuses on short-term consequences for a specific healthcare provider. For instance, a primary care provider may save overall healthcare costs by implementing some recommended practice, but not actually receive the financial savings.

Economic analysis is much broader than cost-effectiveness studies, which provide the famous incremental cost-effectiveness ratio (ICER). Economic methods such as Data Envelopment Analysis can be used to assess the efficiency of providers in providing evidence-based care, and help to identify determinants of efficient practice. Likewise, managers and policy makers can use economic concepts and methods to guide their decisions.

即时通讯plementation of economic analyses in implementation science remains a challenge. The editorial by Hoomans and Severens in实施科学概述了其在健康研究中实施的障碍的方法和探索。

My experience as researcher suggests that most clinicians realize that taking part in implementation programs may imply substantial time investments for them. However, if they agree with the principle that the outcomes of such programs need to be evaluated, it takes only one more step to accept these outcomes need to be balanced with the invested time. In addition, many clinicians and managers understand very well where financial savings are realized, particularly if this is not in their organization.

So, I believe that it is possible for health economists and implementation scientists to find common ground. Hopefully the editorial by Hoomans and Severens will contribute to this.