A review of the application of health economics to health and safety in healthcare.

A literature review is described which aimed to evaluate economic evaluations of health and safety interventions in healthcare. Severe limitations in the methodological rigor of nearly all the published work were identified. Most effort had been invested in costing studies, which are not economic evaluations in their own right. Problems were identified with valuing benefits in health and safety because they frequently take many years to emerge and are difficult to measure. Understanding of economic techniques within the health and safety professions was limited, resulting in wide-ranging assumptions being made as to the positive economic impact of health and safety interventions. Reasons for this are explored and include the subjective benefits of intervention programmes being so impressive and the likelihood of economic savings so great that there have been few demands for objective data. Healthcare managers, health economists, and health and safety professionals have not traditionally worked together and have inherent misunderstandings of each other roles. The review concludes that the aim of future research should be to assist the National Health Service (NHS) to make valid decisions about health and safety investment and risk control methods. This should be done with the aim of improving the health of those affected by or working within the healthcare sector. Copyright 2002 Elsevier Science Ireland Ltd.