Valuing Health Surveillance as an Information System: Interdisciplinary Insights
Valuing Health Surveillance as an Information System: Interdisciplinary Insights
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DOI：
10.3389/fpubh.2019.00138
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发表时间：
2019-06-13
影响因子：
5.2
通讯作者：
Ravel, Andre
中科院分区：
文献类型：
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作者：
Antoine-Moussiaux, Nicolas;Vandenberg, Olivier;Ravel, Andre
与一般信息系统一样，对卫生监测系统和卫生信息进行经济评估是一项方法学挑战。目前的主要思路是考虑成本效益解决办法，最大限度地减少特定技术所需产出的成本，或进行成本效益分析，平衡成本与适当知情的公共干预措施的经济效益。后一种选择遵循线性指挥和控制的观点，意味着考虑信息、决策、行动和健康益处之间的主要因果联系。然而，考虑到信息的性质和多重来源、其处理周期的模式，从生产到传播、分散使用和逐步建立共享信息资本，对信息进行评估是一项有希望的挑战。这项工作提出了对健康监测价值的跨学科洞察，以获得一个新的理论框架，将信息学和信息学理论与信息经济学结合起来。这种反思是基于价值的类型学方法，基本上区分了使用价值和非使用价值。通过这种有条理的讨论，主要思想是扩大监测评价的边界，侧重于变化和趋势、信息系统的动态和网络结构、不同数据的贡献以及定性和定量信息相结合的附加值。与指挥-控制模式保持距离，这一反思考虑了许多健康风险的行为基础，以及风险管理中决策的分散、渐进和深思熟虑的层面。该框架还借鉴了最近在卫生部门内外应用的经验教训，例如在监测抗菌素耐药性、实验室间网络、使用大数据或网络资源、传播技术产品和大规模金融风险方面。最后，本文提出了通过更好地理解卫生信息价值来思考可行的卫生监测经济评估方法所面临的挑战的基础。它的目的是避免过度简化全社会健康信息惠益的范围，同时将评估保持在可能归因于评估信息系统的范围内。
The economic evaluation of health surveillance systems and of health information is a methodological challenge, as for information systems in general. Main present threads are considering cost-effectiveness solutions, minimizing costs for a given technically required output, or cost-benefit analysis, balancing costs with economic benefits of duly informed public interventions. The latter option, following a linear command-and-control perspective, implies considering a main causal link between information, decision, action, and health benefits. Yet, valuing information, taking into account its nature and multiple sources, the modalities of its processing cycle, from production to diffusion, decentralized use and gradual building of a shared information capital, constitutes a promising challenge. This work proposes an interdisciplinary insight on the value of health surveillance to get a renewed theoretical framework integrating information and informatics theory and information economics. The reflection is based on a typological approach of value, basically distinguishing between use and non-use values. Through this structured discussion, the main idea is to expand the boundaries of surveillance evaluation, to focus on changes and trends, on the dynamic and networked structure of information systems, on the contribution of diverse data, and on the added value of combining qualitative and quantitative information. Distancing itself from the command-and-control model, this reflection considers the behavioral fundaments of many health risks, as well as the decentralized, progressive and deliberative dimension of decision-making in risk management. The framework also draws on lessons learnt from recent applications within and outside of health sector, as in surveillance of antimicrobial resistance, inter-laboratory networks, the use of big data or web sources, the diffusion of technological products and large-scale financial risks. Finally, the paper poses the bases to think the challenge of a workable approach to economic evaluation of health surveillance through a better understanding of health information value. It aims to avoid over-simplifying the range of health information benefits across society while keeping evaluation within the boundaries of what may be ascribed to the assessed information system.