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In healthcare there are many different types of decisions to be made. For instance, we may need to decide across many programms which is the most worthwhile, or which is the best mix of programmes. For example, a health authority may have to decide on whether and at what level to fund teenage health clinics or day centres for the elderly. Alternatively, we may have already decided that something is worth doing and we want to define the best way of achieving it. For example, we will try and prevent an infectious disease either by vaccination or by administering gammaglobulin. The conceptual framework of economic evaluation differs according to the type of decisions in question and the viewpoint of the decision-maker. In health services, consequences of interventions are numerous and complex. For instance there are preventive interventions which can avoid the very onset of a disease (e.g. polio immunization), or curative interventions which lengthen survival (cancer treatment), others still that modify the quality of survival (pain relief) and others that modify both (kidney transplants). Some interventions can have negative effects or no effects. Some effects take place both on the patient and his/her family or other patients, or in a more indirect manner on society as a whole, for instance causing productivity losses through sickness. Again, such losses can accrue both to society, the patient or his/her family or carers and their consequences are taken into account in economic evaluation to allow comparison with inputs, as health economics is a science mainly concerned with the bottom line: the total benefits or damage arising from our actions. To provide health care interventions or programmes, we need resources. Resources are all that society owns and uses to provide such programmes. The same resources are not available for an alternative use i.e. they can only be used once. Both tangible items (equipment, premises, drugs, ambulances, materials) and intangible items (time, knowledge and know-how) must be taken into account regardless of whether they are used by and accrue to health services, society, industry or the single individual. In order to make comparisons between the options it is necessary to find a common unit of value for each of the inputs, during and as a consequence of the heath care intervention. If it is relevant for the type of evaluation being conducted, the health consequences are also valued in common units. Complete economic evaluations aim to clarify, quantify and value all of the relevant options, and their inputs and consequences. Cost-Benefit Analysis (CBA) falls into this category. Some approaches fall short of full valuation of all consequences, but are still considered to be economic evaluations. This includes most Cost-Utility Analyses (CUA), Cost-Effectiveness Analyses (CEA) and Cost-Minimisation Analyses (CMA). Many studies of use of resources in health care do not make explicit comparisons between options for care. These are not economic evaluations, but nevertheless can be considered as economic studies and can contribute to our understanding.