经质量调整的寿命年数. 对医生和政策制定者的伦理影响
1Center for Clinical Ethics, Lutheran General Hospital, Park Ridge, IL 60068.
JAMA
|June 6, 1990
概括
对于健康经济学而言,质量调整寿命年 (QALYs) 是一个有争议的问题. 伦理假设和决策的转变使QALYs成为政策问题和临床使用的危险.
科学领域:
- 卫生经济学 卫生经济学
- 医学伦理 医学伦理
- 公共卫生政策 公共卫生政策
背景情况:
- 经质量调整的寿命年 (QALYs) 是经济分析中的健康结果的指标.
- 在健康状态下,QALY包括延长寿命和患者估值的生活质量.
研究的目的:
- 批判性地评估支持在资源分配中使用QALYs的伦理假设.
- 分析QALY实施对临床决策和患者自主权的影响.
主要方法:
- 审查每QALY指南成本的六个核心伦理假设.
- 分析由于QALYs而导致的控制位置和临床接触动态的转变.
主要成果:
- QALY依赖于有关生活质量可衡量的有争议的假设,实用主义,公平,社区与个人偏好,基于年龄的受益能力和医生坚持.
- 质量健康年限引入了从患者自主权和临床判断向社区偏好和正式资源分配工具的转变.
- 这反映并加强了医疗决策中的财务道德.
结论:
- 目前在卫生政策中QALYs的应用是有问题的和投机的.
- 在临床床上使用QALY被认为是危险的.
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