Developing guidance for budget impact analysis
Developing guidance for budget impact analysis
复制标题
DOI：
10.2165/00019053-200119060-00001
复制
发表时间：
2001-01-01
影响因子：
4.4
通讯作者：
Hutton, J
中科院分区：
文献类型：
--
作者：
Trueman, P;Drummond, M;Hutton, J
经济评价在有效配置医疗资源中的作用一直受到广泛的争论。虽然经济证据无疑对购买者有用，但它并没有解决日益关注的负担能力问题。医疗保健购买者不仅关心最大限度地提高效率，还关心保持在年度预算范围内的更简单的目标。这两个目标不一定是一致的。本文探讨了负担能力的问题，负担能力和效率之间的关系，并建立了为什么有一个越来越需要的预算影响模型，以补充经济评估的情况。还审查了目前对这些模型的指导，并得出结论认为，目前这种指导是不够的。其中一些问题得到了解决，并提出了一些关于什么是预算影响建模的最佳做法的想法。这些建议包括考虑透明度、观点的清晰度、数据来源的可靠性、中间和最终终点之间的关系以及新疗法的采用率。它们还包括按人口亚组或适应症分类的干预影响、结果报告、重新部署资源的可能性、时间范围、探索不确定性和敏感性分析以及决策者对模型的访问。由于预算影响模型的性质，该文件没有就建模提供严格的方法指导。其目的是提供一些最佳做法的建议，以及今后研究可以建立的一些基础。
The role of economic evaluation in the efficient allocation of healthcare resources has been widely debated. Whilst economic evidence is undoubtedly useful to purchasers, it does not address the issue of affordability which is an increasing concern. Healthcare purchasers are concerned not just with maximising efficiency but also with the more simplistic goal of remaining within their annual budgets. These two objectives are not necessarily consistent.This paper examines the issue of affordability, the relationship between affordability and efficiency and builds the case for why there is a growing need for budget impact models to complement economic evaluation. Guidance currently available for such models is also examined and it is concluded that this guidance is currently insufficient. Some of these insufficiencies are addressed and some thoughts on what constitutes best practice in budget impact modelling are suggested. These suggestions include consideration of transparency, clarity of perspective, reliability of data sources, the relationship between intermediate and final end-points and rates of adoption of new therapies. They also include the impact of intervention by population subgroups or indications, reporting of results, probability of re-deploying resources, the time horizon, exploring uncertainty and sensitivity analysis, and decision-maker access to the model. Due to the nature of budget impact models, the paper does not deliver stringent methodological guidance on modelling. The intention was to provide some suggestions of best practice in addition to some foundations upon which future research can build.