Cost-effectiveness in ambulatory care: alternative approaches.

By relating health care resources and their use to health outcomes, through a coherent macro resource allocation framework, one can examine the health care system for allocative efficiencies. In this article, costs and outcomes are analyzed in such a framework, scenarios for optimizing the use of health care resources--while still maintaining existing health outcomes--are explored, and the implications for ambulatory care are discussed. The research clearly shows that much can be done to make health care systems more efficient without jeopardizing health outcomes.