Twaddle S, Walker A
Greater Glasgow Health Board, UK.
Health Policy. 1995 Aug;33(2):91-105. doi: 10.1016/0168-8510(95)93671-m.
Recent NHS policy statements advocate the use of 'knowledge-based' purchasing. This paper describes an attempt to use an economic method to inform the purchasing process. The approach of programme budgeting and marginal analysis (PBMA) offers information on current service provision and provides a framework in which changes in a service can be evaluated and agreed within the context of a fixed budget. This has been applied to gynaecology services in Greater Glasgow Health Board and, following positive reaction to the results of this exercise, is now being extended into other areas. The process of carrying out the exercise is described. Additionally, limitations of the approach and the advantages of using PBMA in achieving knowledge-based purchasing are discussed.
英国国家医疗服务体系（NHS）近期的政策声明提倡采用“基于知识的”采购方式。本文描述了一次尝试，即运用一种经济方法为采购流程提供信息支持。规划预算与边际分析（PBMA）方法能够提供有关当前服务提供情况的信息，并提供一个框架，在此框架内，可以在固定预算的背景下对服务变更进行评估并达成共识。该方法已应用于大格拉斯哥健康委员会的妇科服务，鉴于对此项实践结果的积极反馈，目前正扩展至其他领域。文中描述了开展此项实践的过程。此外，还讨论了该方法的局限性以及使用PBMA实现基于知识的采购的优势。
