出版的成本效益分析何时包括社会成本? 一个经验分析,2013-2023年
Divya Patil1, Bengt Liljas2, Peter J Neumann1
1Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
概括
社会成本越来越多地被纳入成本效益分析 (CEA),但仍然不常见. 它们的纳入显著影响了成本效益比率,在以相关性和证据为指导时改善了价值评估.
科学领域:
- 卫生经济学 卫生经济学
- 决策科学 决策科学 决策科学
背景情况:
- 社会成本,包括生产力,运输和护理人员的时间,对于全面的健康经济评估至关重要.
- 之前的分析已经强调了成本效益分析 (CEA) 中社会成本的代表性不足.
研究的目的:
- 从2013年到2023年,追踪包括社会成本在CEA中的趋势.
- 确定影响社会成本纳入的因素.
- 评估社会成本对增量成本和增量成本效益比率 (ICER) 的影响.
主要方法:
- 从塔夫斯医疗中心CEA注册表 (2013-2023) 中分析了7800个CEA.
- 基于研究特征的社会成本纳入的评估.
- 多变量后勤回归以确定研究特征和社会成本纳入之间的关联.
- 评估社会成本对增量成本的影响,并为具有社会视角的研究提供ICER.
主要成果:
- 在2013年至2023年期间,CEA中社会成本的纳入从19%上升到28%.
- 生产力,运输和护理人员的时间是最常见的社会成本组件.
- 在来自斯堪的纳维亚国家和荷兰的分析以及心理健康和免疫研究中观察到更高的包容率.
- 纳入社会成本在72%的研究中降低了增量成本,在74%的研究中降低了ICER,有时超过了成本效益值.
结论:
- 尽管增加不大,但社会成本在CEA中未得到充分利用,具有显著的地理,疾病特异性和基于人口的变化.
- 纳入社会成本可以提高卫生干预措施的价值评估.
- 纳入社会成本应该取决于背景,以相关性,可用的证据和决策需求为指导.
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