引入公平性信息的卫生经济性评价方法与研究进展

Research progress of equity-informative health economic evaluation

传统的卫生经济性评价主要侧重于“效率(efficiency)”最大化,对“公平(equity)”因素的定量考量较为不足。为在传统经济性评价的基础上进一步定量评价不同公平性因素,引入公平性信息的经济性评价方法体系逐渐发展起来。本文梳理总结了5种将公平性考量纳入经济性评价的方法,其中对应用比较广泛的公平加权法、分布式成本-效果分析和扩展成本-效果分析3种方法进行了详细介绍,包括基本理念、数据需求、优缺点等。引入公平性信息的经济性评价方法将为决策者定量权衡医疗资源配置的“效率最大化”和“分配公平”提供有效工具,在我国具有较好的发展前景,但缺乏相关基础数据是当前限制此类方法实践应用的主要挑战之一,也是未来相关领域研究者需要突破的研究壁垒。

Traditional health economic evaluation mainly focuses on efficiency and lacks quantitative consideration of equity.To further quantify different equity factors based on traditional economic evaluation,equity-informative economic evaluations have been gradually developed.This paper reviews and summarizes 5 methods to incorporate equity into economic evaluations,among which the 3 widely used including equity-based weighting(EBW),distributional cost-effectiveness analysis(DCEA),and extended cost-effectiveness analysis(ECEA)are introduced in detail regarding basic concept,data requirements,advantages and disadvantages.The equity-informative economic evaluations will provide an effective tool for decision-makers to trade off between the efficiency maximization and distributional equity in the allocation of health resources formally and transparently,and will have a good prospect in China.However,the lack of relevant basic data is one of the main challenges limiting the practical application of such methods.It is also a research barrier that future researchers in related fields need to break through.