可负担性决策规则:系统审查和框架,用于对卫生系统的预算影响值进行分类
Andres Pichon-Riviere1, Federico Rodríguez-Cairoli2, Michael Drummond3
1Institute for Clinical Effectiveness and Health Policy, National Scientific and Technical Research Council, Buenos Aires, Argentina; School of Public Health, University of Buenos Aires, Buenos Aires, Argentina.
本研究确定了全球卫生干预措施的预算影响值 (BIT). 它提出了四个类别的双边投资协议,以帮助各国一致地做出预算分配决定.
科学领域:
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
- 卫生技术评估 卫生技术评估
背景情况:
- 全球卫生系统面临着对新干预措施的负担能力日益增加的担忧.
- 目前缺乏定义预算影响值 (BIT) 的标准化方法.
- 这项研究解决了评估干预负担能力的一致框架的需求.
研究的目的:
- 系统地确定现有的预算影响值 (BIT).
- 为全球应用提出标准化的BIT类别.
- 为了说明这些估计在182个国家的应用.
主要方法:
- 按照柯克兰方法和PRISMA指南进行系统审查.
- 在 MEDLINE 和 Embase 搜索了关于预算影响或负担能力门的文章.
- 咨询了卫生技术评估机构和标准化的双边投资协议,以占当前卫生支出比例.
主要成果:
- 从5086个记录中,确定了13个国家的22个BIT.
- 定义了预算影响的四个级别:低 (<0.005%),中等 (0.005%至<0.01%),高 (0.01%至<0.02%),非常高 (≥0.02%).
- 较高的双边投资协议与更严格的政策行动相关.
结论:
- 提出了一种强有力的方法来解释全球预算影响.
- 促进跨国比较,并支持知情的预算分配.
- 该框架具有适应性,应根据特定的国家背景量身定制.
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