Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems.

A275was implemented. Tally sheets were used to categorize clinicians counter referral comments. Results: The study engaged 4 clinicians who made 132 counter-referral comments on referral slips delivered to them from CHWs. The comments were categorized into seven themes as indicated below. The theme "service provided and patient counter-referred to CHW" accounted for 40% (53/132); "continue with treatment" 16% (21/132);"medicine/treatment given" 15%(20/132); "patient advised to attend ANC, PNC and MCH/FP clinic" 12% (16/132); "patient recommended for further referral" 7%(9/132); "patient seen" 7% (9/132) and the theme " patient advised to come again" accounted for 3% (4/132.) ConClusions: Clinicians should take an active role in supporting and mentoring community health workers and ensuring that all members of households have access to healthcare. They need to recognize, appreciate and support their efforts. The referral and counter-referral comments made by both clinicians and CHWs acted as a perfect link between the two levels of healthcare.