在预算受限的医疗保健系统中,超越"健康"的价值观
1Department of Economics, University of Rochester, Rochester, NY, USA; Department of Public Health Sciences, University of Rochester, Rochester, NY, USA; Department of Political Science, University of Rochester, Rochester, NY, USA.
概括
本研究引入了新的方法来评估超出质量调整寿命的医疗保健治疗,并将预算受限系统中的额外健康结果纳入其中. 它展示了如何从预算拨款中推断价值,以便更好地评估医疗保健.
科学领域:
- 卫生经济学 卫生经济学
- 福利经济学 福利经济学
- 医疗保健管理的管理
背景情况:
- 目前的医疗保健估值方法,如质量调整寿命年 (QALYs),有局限性.
- QALYs并没有捕捉到与医疗保健治疗相关的所有价值维度.
- 需要采用包含额外健康相关结果的方法,特别是在资源有限的环境中.
研究的目的:
- 开发方法上合理的方法,将额外的健康相关结果纳入医疗保健评估中.
- 专注于预算受限的医疗保健系统,通常不使用标准的福利经济学方法.
- 为评估医疗保健治疗的全部价值提供一个框架.
主要方法:
- 利用额外的福利主义方法在固定预算限制下最大限度地提高总体健康.
- 采用拉格朗日乘数方法进行优化.
- 引入了社会福利功能,以纳入公平考虑,如残疾和疾病严重程度.
主要成果:
- 开发了评估在固定预算情况下支付额外健康价值的意愿的方法.
- 展示了了解医疗保健成本和健康增强如何告知价值评估.
- 在补充材料中提出的分析提供了详细的见解.
结论:
- 在预算受限的系统中,医疗保健价值从实际的预算拨款中推断出来.
- 结合方法允许在医疗保健中从重视"健康"过渡到重视"福利".
- 这些方法提高了医疗保健使用价值增加的测量.
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