使用专家诱导调整已发表的干预效应,以反映当地环境
Jodi Gray1, Tilenka R Thynne2,3, Vaughn Eaton4
1Flinders Health and Medical Research Institute (FHMRI), College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
MDM policy & practice
|January 29, 2024
概括
地方卫生服务可以通过调整已公布的干预效应,使用专家的诱导来改善资金决策. 这种方法增强了新的医疗服务干预措施的经济评估的当地相关性.
科学领域:
- 医疗服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 临床决策的过程
背景情况:
- 当地卫生服务部门在资助新干预措施时未充分利用经济评估.
- 一个主要的障碍是公布的干预效应对当地环境的相关性有限.
- 发表的效果估计通常反映了最初的评估环境,而不是当地现实.
研究的目的:
- 探索使用专家诱导来调整已公布的干预效应以进行当地经济评估.
- 提高经济评估对医疗服务融资决策的当地相关性.
- 评估专家提取方法的可行性和可接受性.
主要方法:
- 专家诱导涉及6名临床专家.
- 系统地介绍发表的研究与当地环境 (患者特征,护理质量,实施范围) 之间的差异.
- 专家们估计了当地环境的现实,悲观和乐观的干预效应大小.
主要成果:
- 专家估计,这两种干预措施在当地效果不如已发表的研究.
- 降低的有效性与较低的患者复杂性和实施范围的差异 (全医院与目标) 有关.
- 提取过程为当地经济评估提供了调整后的效果估计.
结论:
- 实用性专家诱导是调整已公布的干预效应的可行和可接受方法.
- 这种调整提高了经济评估的当地相关性.
- 建议进一步开发和应用这些方法,以支持地方决策.
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