Policies and cost analyses of voluntary assisted dying (VAD) laws - a mapping review & analysis.

IF 2.7 3区 经济学 Q1 ECONOMICS
Sami Isaac, Andrew J McLachlan, Betty Chaar
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引用次数: 0

Abstract

Objectives: To investigate the current literature on healthcare policies and cost analyses around international Voluntary Assisted Dying (VAD) laws. The study design is a mapping literature review following Preferred-Reporting-Items-for-Systematic-Reviews-and-Meta-Analyses (PRISMA) guidelines.

Methods: Original research articles published between January 1990 to March 2023, investigating the financial cost and healthcare budget effect of VAD laws internationally. Citations were screened for relevance and eligibility, and any non-full-text research that did not explore cost analysis was excluded. The following data sources were screened: MEDLINE, PubMed, EMBASE, CINAHL and any relevant international health authority annual reports were also reviewed.

Results: Of the 2790 screened articles, eight studies met the inclusion criteria and three were included in the mapping review. The reviewed studies included prospective studies, two Canadian and one US. Only one of the Canadian studies provided a cost analysis using data from current VAD laws. All three studies showed VAD laws would reduce healthcare spending, with the US approximating $627million in 1995. Canada approximating $17.1 to $77.1million in 2017 and $86.9 to $149.0million in 2021, overall, leading to an average percentage reduction in costs of approximately 87% compared to original costs of end-of-life care.

Conclusion: This review identifies a scarcity in cost-analysis literature and provides a summary of the latest international VAD laws, from which a potential cost reduction is apparent. The absence of retrospectively collated financial VAD data highlights a need for future research to inform policymakers of the economic factors affecting current policies with a need for annual fiscal reports and to optimise future legislative frameworks internationally.

自愿协助死亡(VAD)法律的政策和成本分析--绘图审查与分析。
目的调查有关国际自愿协助死亡(VAD)法律的医疗政策和成本分析的现有文献。研究设计为绘图文献综述,遵循 "系统综述与计量分析的首选报告项目"(Preferred-Reporting-Items-for-Systematic-Reviews-and-Meta-Analyses,PRISMA)指南:方法:1990 年 1 月至 2023 年 3 月间发表的原创研究文章,调查国际上 VAD 法律的财务成本和医疗预算影响。对引文的相关性和合格性进行筛选,排除任何未探讨成本分析的非全文研究。筛选了以下数据来源:MEDLINE、PubMed、EMBASE、CINAHL,并查阅了相关国际卫生机构的年度报告:在筛选出的 2790 篇文章中,有 8 项研究符合纳入标准,其中 3 项被纳入图谱审查。所审查的研究包括前瞻性研究,其中两项为加拿大研究,一项为美国研究。其中只有一项加拿大研究利用现行 VAD 法律的数据进行了成本分析。所有三项研究都表明,VAD 法律将减少医疗保健支出,1995 年美国约为 6.27 亿美元,加拿大约为 1.71 亿美元。加拿大在 2017 年约为 1,710 万至 7,710 万美元,在 2021 年约为 8,690 万至 1.490 亿美元,总体而言,与生命末期护理的原始成本相比,平均成本降低了约 87%:本综述发现了成本分析文献的稀缺性,并对最新的国际 VAD 法律进行了总结,从中可以看出潜在的成本降低。由于缺乏追溯整理的 VAD 财务数据,因此今后需要开展研究,以告知政策制定者影响现行政策的经济因素,同时需要编制年度财务报告,并优化国际上未来的立法框架。
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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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