医疗保健优先级设置中的严重性评估应该是风险和时间敏感的吗?
1Department of Health, Medicine and Caring Sciences, National Centre for Priorities in Health, Linköping University, Linköping, SE-581 83, Sweden. lars.sandman@liu.se.
概括
医疗保健优先级设置需要仔细考虑严重程度. 本分析探讨了严重程度是否应该是风险敏感和时间敏感,影响治疗优先级.
科学领域:
- 卫生经济学 卫生经济学
- 医学伦理学医学伦理学
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗保健优先级的设定在很大程度上依赖于严重性评估.
- 医疗保健中的严重性概念缺乏理论化,导致争论.
- 一个关键的争议是严重程度是否应该对风险和/或时间敏感.
研究的目的:
- 提供关于医疗严重程度是否应该是风险和/或时间敏感的规范性分析.
- 探索严重性评估中风险和时间敏感性的影响,以确定医疗保健优先级.
主要方法:
- 采用了反射平衡方法.
- 分析了关于预防护理严重性的判断和论点.
- 试图在严重性评估和优先级设置的更广泛的规范理论之间保持一致.
主要成果:
- 对风险敏感的严重程度评估可能会稀释感知严重程度,可能会降低有效的预防治疗的优先级.
- 风险在严重程度评估中的相关性取决于定义的人口 (例如,整个风险人口与未来受影响的个体).
- 时间敏感的严重性论点被未来技术进步的潜力所加强,这表明个性化折扣.
结论:
- 根据风险或时间计算严重程度的折扣对医疗保健优先级有重大影响,特别是在预防性干预方面.
- 在评估风险和时间敏感性时,仔细考虑人口划分和未来的技术发展至关重要.
- 必须彻底评估严重性风险和时间敏感性的系统影响,以确保公平的医疗保健资源分配.
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