医疗保健优先设置的经济影响:对当前证据的范围审查
Riikka-Leena Leskelä1,2, Antero Vanhala3, Katariina Gehrmann4
1Faculty of Medicine, University of Helsinki, Helsinki, Uusimaa, Finland riikka-leena.leskela@nhg.fi.
BMJ open
|November 18, 2024
概括
关于医疗保健优先级设置的研究表明,经济效益有限. 很少有研究表明成本节约或制,这表明需要更多关于系统级财务影响的证据.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 卫生政策 卫生政策
背景情况:
- 医疗保健系统面临着越来越大的压力,需要有效管理资源.
- 确定优先级是分配有限的医疗保健资源的关键机制.
- 了解优先级设定的经济影响对于可持续的医疗保健至关重要.
研究的目的:
- 系统地审查和绘制系统层面的医疗保健优先设置对经济影响的现有文献.
- 确定与优先设定倡议相关的财务影响和机会成本.
主要方法:
- 2020年1月至2023年1月期间发表的同行评审文章的全面范围审查.
- 在2023年6月搜索了Scopus电子数据库.
- 包括有经验证据证明财务影响或机会成本的研究,但不包括特定疾病的分析.
主要成果:
- 在8869篇选的文章中,只有15篇符合纳入标准.
- 卫生技术评估是最常见的重点 (7/15).
- 大多数研究没有发现显著的成本节约或制;发现往往是混合的或不确定的 (4/15显示没有节约,8/15混合).
- 只有五项研究表明了一些节省成本或提高效率.
- 许多研究间接或定性地考虑了成本.
结论:
- 显著缺乏关于在卫生服务系统层面明确确定优先级的经济影响的研究.
- 目前的证据表明,通过优先设定方法实现成本控制的成功有限.
- 需要进一步的研究来了解医疗保健优先设定策略的财务影响和有效性.
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