HTA在中低收入国家基本健康福利包设计中的作用。

Health systems and reform Pub Date : 2023-12-31 Epub Date: 2023-11-10 DOI:10.1080/23288604.2023.2273051
Ole F Norheim, David A Watkins
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引用次数: 0

摘要

本评论探讨了健康技术评估(HTA)和健康福利包(HBP)设计之间的关系,以实现中低收入国家的全民健康覆盖(UHC)。它强调,在HTA评估个人医疗干预措施的同时,HBP改革旨在创建综合服务集,考虑到总体人口健康需求和可用资源。LMIC面临的挑战包括当地数据和技术能力有限,导致依赖其他环境的成本效益估计。我们提出了一种实用的方法,通过混合或分区的方法将HTA和HBP元素结合起来。这种方法为特定的医疗保健平台或计划(如初级保健或基本外科手术)设定了不同的成本效益阈值,将优先级设置与组织考虑、道德和实施策略相一致。强有力的机构和学术支持对于基于证据的优先事项制定过程至关重要。总之,HTA可以在LMIC中为UHC设计HBP方面发挥关键作用,而分区方法可以在考虑预算限制和公平的同时加强优先级设置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Role of HTA for Essential Health Benefit Package Design in Low or Middle-Income Countries.

This Commentary explores the relationship between Health Technology Assessment (HTA) and Health Benefits Package (HBP) design to achieve Universal Health Coverage (UHC) in low- and middle-income countries. It emphasizes that while HTA evaluates individual healthcare interventions, HBP reform aims to create comprehensive service sets considering overall population health needs and available resources. Challenges in LMICs include limited local data and technical capacity, leading to reliance on cost-effectiveness estimates from other settings. We suggest a practical approach by combining HTA and HBP elements through a hybrid or compartmentalized method. This approach sets differentiated cost-effectiveness thresholds for specific healthcare platforms or programs (e.g., primary care or essential surgery), aligning priority-setting with organizational considerations, ethics, and implementation strategies. Strong institutions and academic support are vital for evidence-informed priority-setting processes. In summary, HTA can play a pivotal role in designing HBPs for UHC in LMICs, and a compartmentalized approach can enhance priority-setting while considering budget constraints and equity.

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