国家医疗保健经济评估指南中的公平性:必不可少还是无关紧要?
Tuba Saygın Avşar1, Xiaozhe Yang2, Paula Lorgelly3
1National Institute for Health and Care Excellence, UK; University College London, UK.
Social science & medicine (1982)
|August 17, 2024
概括
卫生技术评估 (HTA) 准则往往忽视了公平,优先考虑效率而不是健康公平. 这项研究揭示了HTA机构需要明确地将公平考虑纳入其评估中,以减少全球健康不平等.
科学领域:
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
- 卫生公平性健康公平性
背景情况:
- 卫生系统面临着解决健康不平等问题的挑战.
- 医疗保健经济评估 (HEE) 传统上专注于健康最大化,可能忽视了公平.
- 本研究探讨了卫生技术评估 (HTA) 机构如何将公平原则纳入其指导方针.
研究的目的:
- 系统地比较和对比不同HTA机构的公平原则.
- 分析全球范围内如何在HEE指南中解决公平问题.
- 确定在将公平纳入HTA决策过程中的差距.
主要方法:
- 通过全球网络 (ISPOR,GEAR等) 确定了HTA机构. 在2021年和2023年.
- 从51个国家的46个机构获取并分析了HEE指南.
- 根据出版日期分类指南 (2009年之前与2009年后) 并搜索明确的股权提及和方法.
主要成果:
- 只有30%的HEE指南明确解决了股权假设.
- 在29条指导方针中提到健康公平,但只有14条提供了具体的定义,还有7条建议的方法来纳入不平等.
- 股权经常被视为附加分析而不是核心组件,其融入决策过程仍然不清楚.
结论:
- 在其指南中,HTA机构倾向于优先考虑效率而不是公平性.
- 在不考虑公平限制的情况下,对健康最大化的狭关注阻碍了减少健康不平等的努力.
- 卫生技术评估机构应该明确地重新考虑并将公平性纳入其指导方针和决策框架.
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