低所得国および中所得国における健康評価研究から得られた方法論的洞察
Thomas Gadsden1, Janine Verstraete2, Audrey Moyo3
1The George Institute for Global Health, University of New South Wales, Sydney, Australia.
まとめ
低・中所得国 (LMICs) の健康状態評価研究は増加しており,革新的な方法によって包摂性が向上し,コストが削減されています. しかし,資源の需要は依然として課題であり,既存の価値セットの適応は費用対効果の高い選択肢です.
科学分野:
- 健康 経済
- 研究成果
- 世界保健
背景:
- 評価研究は,指定された好みの方法を使用して,健康状態の有用性値を生成します.
- これらの研究は複雑で資源が密集しており,低・中所得国 (LMICs) で実施が困難です.
- LMICがこれらの課題にどう対処するかを理解することは,世界的に健康経済研究を進めるために不可欠です.
研究 の 目的:
- LMICにおける評価研究は,複雑さと資源密度の課題をどのように対処してきたかを検討する.
- 健康状態の評価を行うためにLMICで採用される方法論的適応と戦略を特定する.
- LMICにおける健康状態の評価の現状と将来の影響を評価する.
主な方法:
- LMICで実施された評価研究のスコーピングレビューが行われました.
- MEDLINE,EMBASE,CINAHL,グレー文学 (2024年4月~6月) が検索対象となった.
- 成人被験者による一般的または疾患特有の機器を用いた研究と,指定好みの技術が含まれて,記述的に合成された.
主要な成果:
- 22のLMICから36の研究が含まれており,2020年以降の出版は著しく増加しています.
- 方法論的適応には"軽い"プロトコル,ポータブルツール,歩行者横断の方法論,理解力,文盲や多言語の参加者を含む.
- EQ-5D-5LとEQ-5D-3Lは最も一般的に使用された計量器であり,全国的に代表的な値セットの開発が一般的であった.
結論:
- 価値評価の研究はLMICで急速に拡大しており,リソースの需要を削減し,包摂性を高めるための実験が増加しています.
- 期待される適応にもかかわらず,評価研究の固有のリソースの需要は,特に低所得層の環境で,その実施を制限し続けています.
- 隣国からの価値セットを適応させることは,自国の開発よりも,いくつかの国にとって費用対効果が高いかもしれません.
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