SETTING HEALTH-CARE PRIORITIES IN OREGON - COST-EFFECTIVENESS MEETS THE RULE OF RESCUE
SETTING HEALTH-CARE PRIORITIES IN OREGON - COST-EFFECTIVENESS MEETS THE RULE OF RESCUE
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DOI：
10.1001/jama.265.17.2218
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发表时间：
1991-05-01
影响因子：
120.7
通讯作者：
HADORN, DC
中科院分区：
文献类型：
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作者：
HADORN, DC
俄勒冈州卫生服务委员会最近完成了其主要职责的工作：创建医疗保健服务的优先列表，从最重要到最不重要。俄勒冈州的优先清单草案受到了批评，因为它似乎更倾向于轻微治疗而不是挽救生命的治疗。这种反应反映了成本效益分析与人类拯救濒危生命的强烈倾向之间存在根本性的、不可调和的冲突：“救援规则”。俄勒冈州的最终优先级列表是在没有考虑成本的情况下生成的，因此比初始列表更直观合理。然而，最终列表的实用性因其在条件和治疗方面缺乏特异性而受到限制。另一种确定医疗保健优先事项的方法是通过仔细定义必要的治疗适应症来规避救援规则。这种方法可能会应用于俄勒冈州的最终名单，以实现更好的特异性。
The Oregon Health Services Commission recently completed work on its principal charge: creation of a prioritized list of health care services, ranging from the most important to the least important. Oregon's draft priority list was criticized because it seemed to favor minor treatments over lifesaving ones. This reaction reflects a fundamental and irreconcilable conflict between cost-effectiveness analysis and the powerful human proclivity to rescue endangered life: the "Rule of Rescue." Oregon's final priority list was generated without reference to costs and is, therefore, more intuitively sensible than the initial list. However, the utility of the final list is limited by its lack of specificity with regard to conditions and treatments. An alternative approach for setting health care priorities would circumvent the Rule of Rescue by carefully defining necessary indications for treatment. Such an approach might be applied to Oregon's final list in order to achieve better specificity.