環境的に持続可能な医療のための優先順位設定:公正な資源配分のための新たなアプローチ
Anand Bhopal1, Martin Hensher2, Andrea J MacNeill3
1Bergen Centre for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
The Lancet. Planetary health
|December 26, 2025
まとめ
医療における優先順位設定は、資源配分に環境的持続可能性を統合することができる。このアプローチは、よりグリーンで気候変動に強い医療システムの開発を支援する。
科学分野:
- 医療経済学
- 環境科学
- 医療倫理
背景:
- 医療システムは環境に大きな影響を与えるが、この側面はしばしば見過ごされている。
- 持続可能で、低汚染で、気候変動に強い医療への世界的な移行が出現している。
- 医療における資源配分は、競合する目標と価値のバランスをとるという課題に直面している。
研究 の 目的:
- 医療の優先順位設定ツールが環境的持続可能性への移行をどのように推進できるかを検討する。
- 既存の医療資源配分フレームワークに環境的配慮を統合する。
- より広範な医療システム変革への影響を検討する。
主な方法:
- 医療における費用対効果、公平性、財政リスク保護などの確立された優先順位設定原則のレビュー。
- 環境的持続可能性を医療技術評価(HTA)および多基準意思決定分析(MCDA)に組み込む方法の分析。
- プログラム予算編成および限界分析(PBMA)などの予算プロセスへの持続可能性の統合の検討。
主要な成果:
- 既存の優先順位設定ツールは、環境的持続可能性の基準を含めるように適応させることができる。
- HTAおよびMCDAに環境要因を組み込むことは、持続可能な医療に向けた資源配分を導くことができる。
- PBMAのような予算プロセスは、環境に配慮した医療イニシアチブに資金を提供する機会を提供する。
結論:
- 優先順位設定フレームワークは、医療を持続可能性に向けて導くために不可欠である。
- 資源配分に環境的配慮を統合することは、医療システムを変革するために不可欠である。
- 持続可能な医療の優先順位設定において、トレードオフをナビゲートし、価値を伝えるためには、体系的かつ透明なアプローチが必要である。
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