[How can priorities be set in medical services? A Swedish model].
[How can priorities be set in medical services? A Swedish model].
复制标题
【医疗服务如何优先排序？
DOI：
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
H. Raspe
中科院分区：
文献类型：
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作者：
T. Meyer;H. Raspe
在卫生保健方面，能够实现的目标与获得的资金之间的差距越来越大。确定医疗的优先次序有助于应对质量改进、合理化以及（视情况而定）适当配给的挑战。本文旨在描述一个模式，对医疗干预措施的优先顺序设置，已制定出沿着在瑞典的卫生保健指南的发展。研究方法主要采用文献分析法、文献分析法和专家访谈法。纵向确定优先事项的模式是基于三个确定优先事项的标准：人的尊严、需要和团结以及1992-1995年议会委员会确定的成本效益。优先级设置的对象是条件-治疗对。最重要的是病情的严重程度和治疗的益处（作为治疗需求的表达）以及成本效率。该模型的特点是对科学证据的明显取向。从1到10的优先级评级不遵循标准化算法，但可以理解为一种综合评估。讨论的重点是将医疗专业纳入纵向优先事项确定准则的制定工作的重要性。
In health care there is a growing gap between what can be accomplished and financed. Priority setting in medicine helps to counteract the challenges of quality improvement, rationalisation, and - as the case may be - rationing adequately. This paper aims to describe a model on priority setting of medical interventions that has been worked out along with the development of health-care guidelines in Sweden. The methods used are a literature analysis and a document analysis as well as expert interviews. The model of vertical priority setting is based on the three priority setting criteria: human dignity, need and solidarity, and cost-efficiency that have been set down by a parliamentary commission from 1992-1995. Objects of priority setting are condition-treatment pairs. Of central importance are the severity of the condition and the benefit of the treatment as an expression of treatment need, as well as cost-efficiency. The model is characterised by a pronounced orientation towards scientific evidence. The priority ratings from 1-10 do not follow a standardised algorithm but can be understood as a comprehensive appraisal. The discussion focuses on the importance of the integration of the medical profession into the development of vertical priority setting guidelines.