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Book Reviews
M.F. D R U M M O N D P r i n c i p l e s o f E c o n o m i c Appraisal in H e a l t h C a r e
Oxford University Press, Oxford, 1980, xvi + 132 pages, £4.95 This book and its companion volume, "Studies in economic appraisal in health care" (review and classification of the existing body of English-language literature), were produced during the author's employment as a Research Fellow at the Institute of Social and Economic Research, University of York. The book is described by the author as a guide produced for non-economists with an interest in economic appraisal in the field of health care. In particular two groups have been catered for namely medical researchers, epidemiologists, clinicians, and other health professionals already engaged in multidisciplinary research, or wishing to add an economic perspective to their appraisals of health service alternatives. "Appraisal is concerned with the analysis of alternative courses of action with a view to assisting choice". "As there will never be enough resources to satisfy human wants completely, it follows that use of resources in a given beneficial activity inevitably involves a sacrifice". Therefore "the criterion of economic efficiency is relevant when considering alternative strategies". "Economic appraisal is a complement to, rather than a substitute for medical (and other technical) appraisal". The above statements represent some of the underlying statements behind the book which is divided into roughly three parts. (1) With the aim of giving the reader an early insight into the likely requirements for an assessment of economic efficiency, the economist's notions of costs and benefits are explored as a basis for a more detailed discussion of the various steps in undertaking an economic appraisal. These steps are - deciding upon the study question; - statement of alternatives to be appraised; - assessment of costs and benefits of the alternatives; - adjustments for timing anduncertainty; - decision rules (calculation of decision indices). (2) With the over-aU aim of,giving some indication of the dilferent levels of~ complexity in eco-
nomic analysis the principles outlined in the first part are discussed in the context of four case studies. In each case the ways in which the methodology of the existing work could be refined is considered. (3) In the light of the achievements and inadequacies outlined in the preceding parts, the third part contains a dicussion of the usefulness of economic appraisal. Three aspects of economic appraisal that are potentially beneficial to clear thinking are underlined; - it embodies a systematic approach to decisionmaking; - it recognizes the scarcity of resources and the principle that decisions should depend upon benefits foregone as well as benefits obtained; - it offers a framework in which value judgements can be made explicit. But it is also stressed that the appraisals themselves consume scarce resources, which could be used to provide care rather than to appraise it! The readers of this review may ask at this stage why a book on health economics is reviewed in the European Journal of Operational Research. The answer is that health economists consider operational research techniques as part of their set of tools in health economics. Maybe the OR-worker has a slightly different view of this situation, but .it is a fact that health economics has gained ground during the recent years and has for instance been made one of the objects in the last meeting of the European Working Group: Operational Research Applied to Health Services. In my opinion as an economist and a member of the above mentioned European Working Group, health economics and operational research have many tangent surfaces. Therefore I can recommend operational researchers who are not already familiar with health economics to read this easy-read guide, written by one of the travelling salesmen in health economics.
Sune Vinderslev PETERSEN Danish Hospital Institute Copenhagen, Denmark D. YARON and C.S. TAPIERO (Eds.) O p e r a t i o n s R e s e a r c h in A g r i c u l t u r e and W a t e r R e sources
Proceedings of the O R A G W A International Conference held in Jerusalem, November 25-29, 1979,
Book R e v w w s
North-Holland, Amsterdam, pages, Dfl. 150.00
1980, xviii+ 586
The book contains 36 papers presented at the ORAGWA international conference held in Jerusalem in November 25-29, 1979. It presents a large review on the possibility of applications of the systems analysis approach in agriculture (with special emphasis on Israel), following the basic questions: "What are the real-life problems our models intend to solve? Do our models provide a better understanding of the problems?..." The collection of the papers is a very good source of information for the agricultural economist, technician and their operations research colleagues. The majority of them will find some of the papers interesting and stimulating for their own work. On the other hand those who wish to obtain a global understanding of Operations Research in agriculture will be overwhelmed by the diversity of themes. If P is the set of the possible agricultural and water resource problems and T is the set of the operations research techniques, then the number of 36 papers, where each of them concerns one or more elements of P × I", is a good introduction into the relation between agriculture and operations research (i.e. into a certain subset of P × T). Eight sections of the book successfully try to structure the relation by structuring P: resource allocation under risk and agricultural development; planning and development; trade, stock and price policies; agrobiological management systems; farm management and extensions; aquifer management; water supply systems; irrigation scheduling and water quality and salinity management. The sections are preceded by 4 review papers where the relation is also structured according to T.
Anthony DUSEK Research Institute of Agricultural Technology Prague, Czechoslovakia Eugene KINDLER Charles University Prague, Czechoslovakia D.J. CASLEY and D.A. LURY
Data Collection in Developing Countries Clarendon Press, Oxford, 1980, xi + 244 pages, £15.00
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D.J. Casley is a statistician with the World Bank in Washington. He formerly worked in Kenya as Senior Adviser with the United Nations Food and Agricultural Organization. D.A. Lury is Professor of Quantitative Social Science at the University of Kent. He has worked in many African countries as a statistician and lecturer. Collecting data consists of a wide scope of aciivities, ranging from the individual compiling information in a library from volumes on national and international statistics, to a team of thousands, conducting a nation-wide census. Casley and Lury, in their book, "Data Collection in Developing Countries", cover a large part of this range, as well as techniques of inquiry from the case study to the census, with major emphasis on data collection by sample survey. The book is largely concerned with household and agricultural surveys, since these present some of the greatest difficulties to the surveyor. It is known that from a socio-economic structural aspect, developing countries are uadergoing rapid demographic, social and cultural changes. This is why special difficulties arise when tbey are being surveyed. The authors hold the view that governmental agencies and the individual researcher can collaborate in survey work. In support of this view, a large amount of this survey work was carried out by government statistics offices, although a number of academic and consultative surveys were also conducted. Casley and Lury address themselves to all statisticians, researchers and systems analysts. They do, however, intend to assist people involved in survey work, especially those who have never worked in developing countries. The book consists of an introduction and fourt e e n chapters which cover the following subjects: (I) The introduction of" sampling (2) Deciding what data to collect (3) Censuses (4) Sample surveys ¢5) The case study ¢6) Some aspects of Survey Design (7) The questionnaire (8) The teal. (9) The collection of the data ¢1o) Data preparation and processing (11) The presentation and release of the data