In this issue of AJDC, Listernick and co-workers present an important report on the efficacy and cost savings of an oral rehydration regimen for infants who were dehydrated as a result of gastroenteritis.1 They add to the burgeoning literature on this technique in two ways: they describe the use of oral hydration in dehydrated infants who are managed as outpatients in the United States, and they assess the cost-effectiveness of this approach. Much has been written of the former; the latter has just begun to enter many physicians' consciousness in day-to-day reality.
As this manuscript was revised, considerable discussion emerged as to whether the emphasis was misplaced, ie, were we now looking at cost-effectiveness and not at the "best" method for treating a specific condition? The authors acknowledge this controversy by stating, "Cost containment should be an integral part of medical care, although never at the expense of either