在以价值为基础的卫生系统中创造价值的构建块:德尔菲研究
Alexander W Carter1, Caitlin Main2, Avinash Cherla1
1Department of Health Policy, LSE Health, London School of Economics and Political Science, London, England, UK.
概括
这项研究制定了一个框架,以确定推动健康技术价值和系统障碍的因素. 基于共识的方法结合了各种利益相关者的意见,以改善医疗保健系统的资源分配和价值捕获.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生技术评估 卫生技术评估
- 卫生经济学 卫生经济学
背景情况:
- 识别推动健康技术价值的因素对于有效的资源配置至关重要.
- 现有的框架可能无法充分捕捉医疗保健系统中价值创造的复杂性.
- 需要一个结构化的方法,以纳入不同的利益相关者的观点和系统层面的因素.
研究的目的:
- 制定一个以共识为导向的框架,定义影响健康技术价值创造的关键因素.
- 识别可能阻碍卫生技术影响的系统层面障碍.
- 为医疗技术价值评估提供基于证据的,以系统为中心的方法.
主要方法:
- 一种混合方法的方法,结合了有针对性的文献审查和3轮基于网络的Delphi练习与22名专家.
- 最初的框架草案由21个现有框架提供信息.
- 对专家贡献的价值陈述进行主题分析,然后对共识建立进行利克特级别评级.
主要成果:
- 一项范围审查确定了10个价值域和46个子域.
- 德尔菲演习在38个子域中产生了61个价值声明.
- 17个价值陈述取得了共识和稳定性,形成了最终框架的基础.
结论:
- 开发的价值框架为健康技术价值评估提供了基于证据的,以系统为中心的方法.
- 该框架整合了各种利益相关者的观点和关键的系统因素,解决了当前价值捕获的差距.
- 建议进行进一步的研究,以验证在各种医疗保健机构中确定的域名和子域名.
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