International Journal for Equity in Health Open Access Priority Setting in Health Care: Lessons from the Experiences of Eight Countries the Challenge
International Journal for Equity in Health Open Access Priority Setting in Health Care: Lessons from the Experiences of Eight Countries the Challenge
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国际卫生公平杂志 卫生保健开放获取优先事项设置：挑战八个国家的经验教训
DOI：
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发表时间：
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期刊：
影响因子：
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通讯作者：
R. Lie
中科院分区：
文献类型：
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作者：
Lindsay M Sabik;R. Lie
所有卫生保健系统都面临着公正和效率方面的问题，这些问题与确定将有限资源分配给人口的优先事项有关。由于许多核心问题在所有系统中都是相同的，美国和其他国家可以从那些明确解决卫生保健优先问题的国家的成功和失败中吸取教训。以及美国的俄勒冈州。所使用的方法可以分为以概述原则为中心的方法和以定义实践为中心的方法。为了从他们的经验中建立主要的教训，我们考虑(1)每个国家使用的过程，(2)判断这些努力成功的标准，(3)哪些方法似乎符合这些标准，以及(4)以他们的成功和失败为指导，如何继续确定优先事项。我们表明，几乎没有证据表明，为确定优先事项建立的价值框架对卫生政策产生了任何影响，也没有证据表明，确定优先事项的工作导致了公众公开和参与决策的设想理想。卫生保健系统面临的一个主要挑战是资源有限，因此不可能向每个人提供他们可能需要或想要的所有有效干预措施。稀缺性提出了公正和效率的问题：有限的卫生保健资源应该如何分配？哪些卫生服务应由公共资助？如何确定特定干预措施的适应症？[1 - 6]。卫生保健的优先级设置或配给仍然是一个充满政治色彩的话题，但最近它的必要性得到了更广泛的认识[7-11]。明确解决确定优先事项的问题对于制定更公平的分配稀缺卫生保健资源的方法[7,10,12]和开始公开对话以确保这一进程的合法性[3,5]是必要的。英国和美国俄勒冈州已明确努力解决卫生重点问题。虽然它们的系统不同，但许多核心分配问题是相同的[13-21]。各国卫生保健的筹资方式各不相同（表1）。一些国家，如英国和斯堪的纳维亚国家，有以税收为基础的国家，允许在任何媒介上不受限制地使用、分发和复制，只要原始作品被适当引用。
All health care systems face problems of justice and efficiency related to setting priorities for allocating a limited pool of resources to a population. Because many of the central issues are the same in all systems, the United States and other countries can learn from the successes and failures of countries that have explicitly addressed the question of health care priorities. and the state of Oregon in the US. The approaches used can be divided into those centered on outlining principles versus those that define practices. In order to establish the main lessons from their experiences we consider (1) the process each country used, (2) criteria to judge the success of these efforts, (3) which approaches seem to have met these criteria, and (4) using their successes and failures as a guide, how to proceed in setting priorities. We demonstrate that there is little evidence that establishment of a values framework for priority setting has had any effect on health policy, nor is there evidence that priority setting exercises have led to the envisaged ideal of an open and participatory public involvement in decision making. One main challenge for health care systems is that resources are limited, making it impossible to provide everyone with every effective intervention they might need or want. Scarcity raises questions of justice and efficiency: how should limited health care resources be allo-cated? What health services should be publicly funded? How should indications for particular interventions be defined? [1-6]. Priority setting or rationing in health care continues to be a politically charged topic, but recently its necessity has gained wider recognition [7-11]. Explicitly addressing priority setting is necessary to develop fairer methods of allocation for scarce health care resources [7,10,12] and to begin a public dialogue to ensure legitimacy in the process [3,5]. and the United Kingdom, and one state in the US, Ore-gon, that have made explicit efforts to address health priorities. While their systems differ, many core allocation issues are the same [13-21]. The countries vary in how health care is financed (Table 1). Some, such as the UK and the Scandinavian countries, have tax based national which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
影响因子：
3.5
作者：
Garber, AM;Phelps, CE
通讯作者：
Phelps, CE
成本效益和证据评估作为承保政策的标准。
DOI：
10.1377/hlthaff.w4.284
发表时间：
2004
期刊：
Health affairs (Project Hope)
影响因子：
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作者：
Garber,AlanM
通讯作者：
Garber,AlanM