通过成本效益分析来维持健康差异的风险
Sanjay Basu1, Atheendar S Venkataramani2, Dean Schillinger3
1Sanjay Basu (sanjay.basu@waymarkcare.org), Waymark, San Francisco, California.
Health affairs (Project Hope)
|August 5, 2024
概括
标准的成本效益分析可能低估了对边缘化群体的干预效益. 调整健康不平等和结构因素对于公平的健康政策决策至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 健康 公平 研究 健康 公平 研究
- 公共卫生政策 公共卫生政策
背景情况:
- 成本效益分析 (CEA) 对卫生政策至关重要,但可能会延续不平等.
- 标准CEA可以通过假设持续的健康差异,使边缘化人口处于不利地位.
研究的目的:
- 检查竞争风险,基线成本和间接成本如何影响少数群体的CEA.
- 突出结构因素如何减少对弱势群体的预计干预效益.
主要方法:
- 对影响CEA结果的结构因素的分析.
- 使用干预措施的说明性示例,例如含糖饮料税.
主要成果:
- 结构因素可能会减少少数群体的质量调整寿命和成本节约.
- 由于这些因素,干预措施可能对弱势群体来说成本效益较低.
- 竞争风险和保险状况的差异影响CEA的结果.
结论:
- 目前的CEA方法可能会系统地使边缘化社区处于不利地位.
- 需要采用替代CEA方法来考虑结构因素并减少不平等.
- 卫生公平敏感性分析可以支持有利于弱势群体的干预措施.
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