经济评估和护理委托是否专注于实现相同的结果? 使用英格兰作为案例研究的资源分配考虑和挑战
Matthew Franklin1, Sebastian Hinde2, Rachael Maree Hunter3
1Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. matt.franklin@sheffield.ac.uk.
Applied health economics and health policy
|March 12, 2024
概括
基于结果的委托旨在获得金钱的价值,但将支付结构与健康结果联系起来需要仔细考虑. 弥合经济评估和护理委托之间的差距对于有效的资源配置和改善患者护理至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 医疗服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
背景情况:
- 根据需求和支付结构,委托合同提供护理服务.
- 基于结果的委托和经济评估都旨在从有限的预算中获得金钱的价值.
- 在经济评估证据和实际护理委托之间存在差距.
研究的目的:
- 探索相关成果在评估和调试中的实际作用.
- 弥合经济评估证据和护理委托实践之间的差距.
- 检查将结果与支付机制联系起来时的概念和实际挑战.
主要方法:
- 基于结果的委托的概念和实践考虑的审查.
- 分析经济评估 (例如,QALY) 与委托代理结果 (例如,健康监测) 之间的联系.
- 使用英格兰的委托系统来说明挑战的案例研究.
主要成果:
- 经济评估通常使用终点结果 (QALY),而委托通常使用替代结果以方便测量和支付链接.
- 将支付与替代结果或终点结果联系起来可能会导致市场效率低下,例如专注于特定的患者群体或无效的干预措施.
- 需要对支付结构,替代结果和经济结果之间的联系进行明确的核算.
结论:
- 弥合经济评估和委托之间的差距需要了解支付结构和健康结果之间的联系.
- 决策分析模型可以帮助委托,但必须结合代理/终点结果,支付和系统交互.
- 有效的调试需要将支付机制与所需的健康结果保持一致,以确保金钱的价值并避免市场扭曲.
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