Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues.
Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues.
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DOI：
10.1186/1471-2458-13-1001
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发表时间：
2013-10-24
影响因子：
4.5
通讯作者：
Lloyd-Williams H
中科院分区：
文献类型：
--
作者：
Edwards RT;Charles JM;Lloyd-Williams H
如果公共卫生是社会如何共同致力于改善健康和减少健康不平等的科学和艺术，那么公共卫生经济学就是支持决策的科学和艺术，社会如何利用其可用资源来最好地实现这些目标并最大限度地减少机会成本。对在这一广泛的公共政策范式内对公共卫生干预措施进行经济评价的出版指南进行了系统审查。使用22年的时间范围（1990-2012）搜索电子数据库和组织网站。手动检索论文参考文献，以纳入其他论文。政府报告或经同行评审的已发表论文如果提及公共卫生干预措施的经济评价方法，确定对公共卫生干预措施进行经济评价的主要挑战，或就对公共卫生干预措施进行经济评价提出建议，则将被纳入。指南分为三类：英国指南、国际指南和公共卫生经济学领域个别评论员提供的观察或指南。对指导的理论框架进行了评估，并将其作为对论文进行分类的依据。我们确定了5份国际指导文件，7份英国指导文件和4份个人评论员文件。所审查的文件确定了分析人员在进行此类评价时面临的主要方法挑战。指南中有一个共识，即由于公共卫生的复杂性，应该考虑更广泛的社会和环境成本和效益。这反映在理论基础上，因为大多数指导被归类为额外福利主义。在这篇新颖的评论中，我们认为卫生经济学可能已经从其广泛的公共政策经济学的根源中走了一个完整的循环。我们可能会发现，在公共卫生经济学方面，用这种更广泛的范式来思考是有用的。我们提供了一个12点的清单，以支持政府，NHS专员和个人卫生经济学家在他们考虑的经济评估方法方面的应用卫生经济学公共卫生的额外挑战。
If Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted. Electronic databases and organisation websites were searched using a 22 year time horizon (1990–2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers. We identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist. In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may find it useful to think in this broader paradigm with respect to public health economics. We offer a 12 point checklist to support government, NHS commissioners and individual health economists in their consideration of economic evaluation methodology with respect to the additional challenges of applying health economics to public health.