Cost Utility Analyses in International Disaster Responses—Where Are They?

Abstract

International health care providers have flocked to Haiti and other disaster-affected countries in record numbers. Anecdotal articles often give "body counts" to describe what was accomplished, followed months later by articles suggesting outcomes could have been better. Mention will be made that various interventions were "expensive," or not the best use of limited funds. But there is very little science to post-intervention evaluations, especially with regard to the value for the money spent. This is surprising, because a large body of literature exists with regard to the Cost Utility Analysis (CUA) of health care interventions. Applying reproducible metrics to disaster interventions will help improve performance.This study will: (1) introduce and explain basic CUA; (2) review why the application of CUA is difficult in disaster settings; (3) consider how disasters may be unique with regard to CUA; (4) demonstrate past and theoretical utilization of CUA in disaster settings; and (5) suggest future utilization of CUA by healthcare providers in Disaster Response.

Practical application of cost-utility analysis in summative evaluation

“…AGAINST SIMILAR PROGRAMMES: Zoraster’s (2012) findings were reiterated in this research, nominally that disasters ‘vary in many unpredictable ways’ (p. 201). VfM comparisons across disasters is not an ‘apples-to-apples’ comparison.…”

“…CUA has been widely used in disaster recovery interventions (Zoraster, 2012). This method is participatory and synthesises multiple outcomes into one ‘utility’ figure for each alternative approach.…”