替代方法论和结构假设对成本效益分析结果的影响:使用三个印度经济评估的实证证据
Deepshikha Sharma1, Arun Kumar Aggarwal2, Pankaj Bahuguna3,4
1Project Co-Ordinator, Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
经济评估中的不同假设对成本效益结果产生重大影响. 标准化和国家具体指导方针对于医疗保健中可靠的资源分配决策至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 决策科学 决策科学 决策科学
- 公共卫生政策 公共卫生政策
背景情况:
- 经济评估对于医疗保健资源分配至关重要.
- 尽管取得了进展,但EE方法的不确定性仍然存在,影响了决策.
研究的目的:
- 评估不同的方法和结构假设如何影响成本效益分析 (CEA) 结果.
- 评估折扣率变化,时间地平线,研究前景和健康结果措施对CEA的影响.
主要方法:
- 使用了三种已建立的基于模型的经济评估:IMNCI,多发性骨髓瘤和安全工程注射器 (SES) 干预.
- 进行经验分析,以检查改变假设对增量成本效益比率 (ICER) 和整体成本效益解释的影响.
主要成果:
- 较高的贴现率增加了ICER,但没有改变结论. 较短的时间视界显著提高了ICER,改变了SES和多发性髓瘤干预措施的成本效益.
- 使用因残疾调整的生命年 (DALY) 而不是因质量调整的生命年 (QALY) 增加了ICERs. 一个社会观点通常减少了ICER,使IMNCI干预节省了成本.
结论:
- 在EEs中的替代假设显著改变了ICER,可能会影响资源分配.
- 这些发现支持了对EE标准化流程的需求,以及制定国家具体指导方针,以确保可靠的决策.
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