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グループ間での健康の評価:ブータンの人口を横断した支払意向調査
Ying Yao1, Md Mizanur Rahman2, Pempa3
1Faculty of Economics, Keio University, Tokyo, Japan.
BMJ global health
|August 21, 2025
まとめ
ブータンの世帯は,収入と教育によって異なる推定値で,健康上の利益 (WTP) を支払う意思を示しています. これらの結果は,医療資源の配分のための国家費用対効果の値 (CET) に基づいています.
科学分野:
- 健康 経済
- 公衆衛生政策
- 研究 に 対する 支払い の 意向
背景:
- 環境特有の費用対効果基準 (CET) は,低所得国や中所得国の医療資源の配分に不可欠です.
- 社会的支払意向 (WTP) は,これらの値の重要な決定因子です.
- ブータンのヘルスケアシステムは 効果的な資源配分のために 地域のWTPを理解する必要があります
研究 の 目的:
- ブータンで,特に品質調整生命年 (QALY) に対して,健康上の利益 (WTP) を支払う社会的意思を調査する.
- ブータンにおけるコンテキスト特有の費用対効果の値 (CET) の開発に情報を提供すること.
- ブータンの人口の健康に WTP を影響する要因を分析する.
主な方法:
- ブータンの全国的な調査 (n=1869世帯) は,2023年の国民健康調査と共に実施されました.
- 回答者は健康状態の改善を想定して評価した.
- 一般化された線形回帰と多層分析を使用してWTPを推定し,変化を調べた.
主要な成果:
- WTPの推定値は,1つのQALYで104,381ブータンンングルラム (BTN) と,5つのQALYで235,237BTNでした.
- WTPは,個々の収入と教育水準に基づいて,区内で大きく変化しました.
- 地域によって WTP の変動は最小でした.
結論:
- 地域間のWTPの最小変動は,ブータンのための国家レベルの費用対効果の値 (CET) をサポートします.
- WTPベースのCETは,より高い所得とより高い教育を受けたグループによって向上傾向がある可能性があります.
- この潜在的なバイアスは高価な技術の採用につながり,ブータンの公衆衛生資源を圧迫する可能性があります.
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