Generalized cost-effectiveness analysis for national-level priority-setting in the health sector.
Generalized cost-effectiveness analysis for national-level priority-setting in the health sector.
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DOI：
10.1186/1478-7547-1-8
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发表时间：
2003-12-19
期刊：
影响因子：
--
通讯作者：
Edejer, Tessa Tan-Torres
中科院分区：
文献类型：
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作者：
Hutubessy, Raymond;Chisholm, Dan;Edejer, Tessa Tan-Torres
成本效益分析可能是公共卫生决策的重要辅助手段，但除了一些明显的例外情况，其在个别国家一级的使用和影响有限。造成这种情况的原因可能有几个，其中包括与产生当前经济证据有关的技术缺陷、政治上的权宜之计、社会偏好和执行方面的系统性障碍。作为部门成本效益分析的一种形式，普遍成本效益分析着手克服在区域和国家一级适当使用成本效益信息的一些障碍。通过世卫组织-选择方案应用这一方法提供了一个新的经济证据基础，以及基本的方法学发展，涉及一系列针对疾病主要原因和风险因素的卫生干预措施的成本效益，世卫组织-选择方案提供的不同干预措施的估计次区域成本和效果可随时根据各国的具体情况加以调整，例如，通过调整干预投入的数量和单价（成本）或干预措施的覆盖面、功效和坚持率（有效性）。这一信息对卫生政策和规划的潜在用途是评估目前的干预战略是否有效利用了稀缺资源，以及哪些潜在的额外干预措施尚未实施或未充分实施，卫生政策制定者和规划管理者可以利用世卫组织的成果，“选择”是对国家一级服务规划和优先次序的宝贵投入，也是进一步分析干预措施在促进健康方面的效率与其对减少不平等和改善穷人健康等其他关键成果的影响之间的权衡的起点。
Cost-effectiveness analysis (CEA) is potentially an important aid to public health decision-making but, with some notable exceptions, its use and impact at the level of individual countries is limited. A number of potential reasons may account for this, among them technical shortcomings associated with the generation of current economic evidence, political expediency, social preferences and systemic barriers to implementation. As a form of sectoral CEA, Generalized CEA sets out to overcome a number of these barriers to the appropriate use of cost-effectiveness information at the regional and country level. Its application via WHO-CHOICE provides a new economic evidence base, as well as underlying methodological developments, concerning the cost-effectiveness of a range of health interventions for leading causes of, and risk factors for, disease.The estimated sub-regional costs and effects of different interventions provided by WHO-CHOICE can readily be tailored to the specific context of individual countries, for example by adjustment to the quantity and unit prices of intervention inputs (costs) or the coverage, efficacy and adherence rates of interventions (effectiveness). The potential usefulness of this information for health policy and planning is in assessing if current intervention strategies represent an efficient use of scarce resources, and which of the potential additional interventions that are not yet implemented, or not implemented fully, should be given priority on the grounds of cost-effectiveness.Health policy-makers and programme managers can use results from WHO-CHOICE as a valuable input into the planning and prioritization of services at national level, as well as a starting point for additional analyses of the trade-off between the efficiency of interventions in producing health and their impact on other key outcomes such as reducing inequalities and improving the health of the poor.