加拿大卫生系统资源分配的公共偏好:系统性审查
Shehzad Ali1,2,3,4,5, Roxanne Garaszczuk6, Jessica Moodie7
1Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. shehzad.ali@uwo.ca.
加拿大公众的偏好表明,他们倾向于优先考虑儿童和年轻人的医疗保健,而不是老年患者. 然而,关于在社会经济因素之间评估健康公平的证据仍然有限,这突显了当前研究中的差距.
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:
- 传统的经济评估优先考虑健康最大化,忽视社会偏好和对健康差异的担忧.
- 公平信息化的经济评估方法正在出现,将社会价值观纳入资源分配决策中.
- 这些方法利用偏好诱导的定量证据来指导卫生系统资源分配.
研究的目的:
- 系统地审查加拿大关于公众对医疗保健资源分配的偏好研究.
- 调查加拿大人如何在不同社会群体和健康状况中优先考虑医疗保健.
主要方法:
- 对三个数据库 (Embase,MEDLINE,EconLit) 和参考列表进行了系统审查.
- 包括的研究是基于调查的,采样了加拿大居民,并涉及对资源分配或健康再分配的偏好诱导.
- 质量和非偏好研究被排除在外;使用CLARITY Group工具评估了偏差风险.
主要成果:
- 八项涉及8,969名参与者的研究显示,人们更喜欢优先考虑儿童和年轻患者,而不是老年患者.
- 公众对社会经济健康不平等的厌恶是多样化的,并且与受访者特征有关.
- 没有明确的偏好出现罕见疾病比常见的疾病,或基于基线健康状况.
结论:
- 有证据表明,在加拿大,优先考虑年轻人而不是老年人的医疗保健资源.
- 关于社会价值观的加拿大证据显著缺乏,这些证据涉及与社会经济地位,性别/性别以及种族/种族相关的健康不平等.
- 未来的研究应该解决这些差距,以更好地告知公平的卫生资源分配.
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