A study measures healthcare costs and QALYs over only 3 months after surgery. What limitation may exist?

• A. Time horizon may be too short
• B. Indirect costs
• C. Downstream cost savings
• D. Dominant

Answer: (A)

The main concept is that the length of the follow-up period, or time horizon, in economic evaluations determines what costs and health effects you can capture. Measuring costs and QALYs for only three months after surgery may miss outcomes that unfold later, such as long-term benefits, late complications, ongoing health needs, or cost offsets that appear after the initial period. Because QALYs reflect both survival and quality of life over time, a too-short horizon can understate both total benefits and total costs, potentially biasing conclusions about value. Extending the horizon to cover longer-term outcomes gives a fuller picture of whether the surgery provides ongoing value. Indirect costs and downstream cost savings relate to perspective and longer-term consequences, but the core limitation here is simply that a three-month window may be too short to capture all relevant costs and QALYs. Dominant is about comparing options, not about the horizon itself.