医疗保健优先级设定中的严重性和时间性 - 一种特定条件可影响的时间中立方法的案例
1National Centre for Priorities in Health, Department of health, medicine and caring sciences, Linköping university, Linköping, Sweden. lars.sandman@liu.se.
确定医疗保健优先级需要公平的资源分配. 这项研究主张对疾病严重程度进行时间中立的评估,以确保公平的决策,重点关注完整的病情,而不是其时间进展.
科学领域:
- 卫生经济学 卫生经济学
- 医学伦理 医学伦理
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗保健系统面临着公平分配稀缺资源的挑战.
- 疾病的严重程度是基于需求的资源分配的一个关键因素.
- 严重程度的概念,特别是它的时间方面,在医疗保健优先设定中仍然没有得到充分的理论化.
研究的目的:
- 分析时间方面应该如何为成本效益分析中的严重性评估提供信息.
- 调整现有的关于时间性和分配正义的讨论,以适应实际的医疗保健优先设定.
- 提出一个框架,将时间考虑纳入资源分配的严重性评估.
主要方法:
- 在医疗保健优先设置中对严重性和暂时性的概念分析.
- 审查关于时间性和分配正义的讨论.
- 开发一个时间中立的视角来评估条件的完整持续时间.
主要成果:
- 倡导时间中立的严重程度评估,考虑条件的全部可影响的延伸.
- 拒绝根据时间进展或对未来的折扣来修改严重性的概念.
- 在严重程度评估中,没有支持考虑某种情况的"形状" (例如,下降,倾斜,间歇).
结论:
- 建议采用量化方法,在这种方法中,每一个严重程度差异都会影响优先设定.
- 这种方法在实际的医疗保健优先设定决策中被认为是实际有用的.
- 强调对疾病严重程度的综合性,时间中立的观点对于公平的资源分配的重要性.
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