Economic evaluation of quality assurance programmes

Substantial investments are now being made in quality assurance programmes throughout the developed world. Proposes that economic evaluation is one approach to justifying these in terms of value for money. Three key elements are: comparison with some alternative course of action; measurement of costs; and measurement of consequences. Illustrates the difficulties of addressing these by a case‐study –an audit programme aiming to increase the use of intravenous thrombolysis for acute myocardial infarction. Discusses the production of accurate costings; the wide confidence limits associated with regression analysis; and the numerous assumptions required in the modelling of effectiveness. Economic evaluation of quality assurance programmes may be useful in future, if the required data can be collected.