“Clinical Neuropsychology and Cost Outcome Research” is the initial volume of the National Academy of Neuropsychology Book Series, “Neuropsychology: Scientific Basis and Clinical Application.” The editors of the book, who are well-known for both their clinical expertise and research accomplishments, have arranged for other well-known leaders in the field to author the individual chapters of this book.

The main premises of the book are that there is a need for “neuropsychologists to demonstrate to health care economics, government officials, and third party payers the value of their services,” and that we must begin to educate neuropsychological trainees in the economics of neuropsychology and health care early in their careers. In the Preface, Drs. Prigatano and Pliskin note that if the specialty is to survive in the future it is incumbent upon us to demonstrate the subjective and objective value of what we do. The authors propose this book as a beginning text for this area (indeed, subtitling the book, “A Beginning”), and state that there actually is very little research to date on the cost-benefit of neuropsychological services.

The book begins with introductory chapters on health care, economics, and neuropsychology, followed by eight different sections on CNS disorders and professional services/issues. In the introductory chapters the rationale is presented for why cost outcome research is needed, with examples of how cost outcomes research can be conducted. Based on a model by Drummond et al. (1998), the authors provide examples of several methods by which to conduct cost-outcomes research, including cost-minimization, cost-effectiveness, cost-utility, and/or cost-benefit analyses. Based on this model, the majority of chapters in the book provide hypothetical examples of neuropsychological cost outcomes analyses for different neuropsychological disorders. The last chapter of the book, “Measuring the Economics of Neuropsychology,” provides general information on, and an excellent overview of, the main issues involved in cost-outcomes research for all health care professions. This chapter may be the most useful one in the book, and should be read at the beginning with the introductory chapters.

After the introductory chapters, Part I through VI focus on specific central nervous system disorders, including traumatic brain injury, cerebral vascular disorders, neoplasms, dementia, epilepsy, and learning disabilities. Each of these chapters present basic clinical information related to these clinical disorders, subjective benefits of testing persons with the disorder, previously published economic outcome studies related to the disorders (which are few), and case examples of how cost outcomes research can be conducted for persons with the disorder. Although some chapters provide information regarding objective costs associated with the disorders (e.g., total annual health care expenditures for the different disorders), a few present no data on cost outcomes which is a problem for a book of this nature. These latter include the chapters on TBI, physician competency, and forensics. Clinical and economic outcome data on rehabilitation and psychotherapy appear in Part VII. Part VIII deals with special topics (e.g., assessment of competency of physicians, forensic neuropsychology, malingering, and measuring the economics of neuropsychology).

The primary value of this book is its information about the existing literature regarding cost-outcomes research and issues, and the rationale for why neuropsychological cost-outcomes research is needed. In addition, the editors/authors have provided a framework from which to conduct future neuropsychological cost outcomes research (i.e., cost-minimization, cost-effectiveness, cost-utilization, cost–benefit analyses), as well as examples on how such research can be completed. Some chapters provide more and better cost-outcomes data than others, and include very helpful information regarding the long-term costs associated with specific disorders (e.g., CVA, dementia, epilepsy, cognitive rehabilitation, malingering). For example, the chapter on non-epileptic seizures gives excellent data on how the use of inpatient video-EEG seizure monitoring leads to decreased health care utilization, which is an excellent model for future neuropsychological cost outcomes research.

Although the rationale for the book is sound, its primary weakness is that there has been very little research to date on neuropsychological cost outcomes. As a result, many of the chapters primarily read as basic, introductory chapters on the neuropsychological evaluation of different CNS populations. In addition, several chapters, although well written, cover topics that do not appear to fit well with the theme of the book (e.g., “Neuropsychological Assessment of Physicians Whose Competency to Practice Medicine is Being Questioned”; “Clinical Neuropsychology in the Forensic Arena”).

This book can be helpful to clinical neuropsychologists in informing them regarding existing cost-outcomes research on specific CNS populations. However, the majority of material in the book may be of limited usefulness to clinicians as the chapters primarily present only introductory clinical information related to specific CNS disorders. The book will be most useful to neuropsychological researchers, as it provides basic information regarding existing cost-outcomes data, and provides suggestions and examples for the type of cost outcomes research which should be conducted in the future. As promised, the book is a good “beginning,” and hopefully will lead to further and much needed cost outcomes research, which can be more fully presented in a second edition of the book.