Ruta D A, Donaldson C, Gilray I
Department of Public Health Medicine, Tayside Health Board, Dundee, UK.
J Health Serv Res Policy. 1996 Oct;1(4):185-93. doi: 10.1177/135581969600100402.
In this paper it is shown how the economics framework of programme budgeting and marginal analysis (PBMA) can be used to help formulate a purchasing strategy in health care; in this case, for child health services. The basic premise of PBMA is that to have more of some services it is necessary to have less of others. Therefore, it is important to know how resources are currently spent, what changes can be made, and what are the possible costs and benefits of such changes. Despite a lack of evidence on the effectiveness of services, PBMA provides a pragmatic purchasing framework. This framework permits consideration of national policy, local epidemiology, current spending, and the views both of parents and professionals as to how such spending can be changed.
本文展示了如何运用规划预算和边际分析（PBMA）的经济学框架来帮助制定医疗保健采购策略；在此案例中，是针对儿童保健服务。PBMA的基本前提是，要增加某些服务的提供量，就必须减少其他服务的提供量。因此，了解资源目前的使用方式、可以做出哪些改变以及这些改变可能带来的成本和收益非常重要。尽管缺乏关于服务有效性的证据，但PBMA提供了一个务实的采购框架。该框架允许考虑国家政策、当地流行病学情况、当前支出以及家长和专业人士对于如何改变此类支出的看法。
