Keaney M, Lorimer A R
Scottish Clinical Audit Resource Centre, Department of Postgraduate Medical Education, University of Glasgow, UK.
Health Care Anal. 1998 Sep;6(3):208-15. doi: 10.1007/BF02678106.
If the exclusive promotion of values inimical to our basic humanity extends to the health care policy arena, we face a defensive, restricted, impersonal and ultimately impoverished health care system. Americans known it already as 'managed-care'. This is why it is crucial for health policy analysts to make explicit the role of values in policy-making, especially that involving the input of 'value-neutral' economics. The nature of any clinical effectiveness policy will be determined by the understanding of cost-effectiveness employed in its design and implementation. Given that cost-effectiveness is nowadays usually defined according to health economists' criteria, the battle over the meaning of clinical effectiveness is a significant development in health economics' move to assume control of the NHS.
如果对我们基本人性有害的价值观的独家推广延伸到医疗保健政策领域，我们将面临一个防御性的、受限的、冷漠的，最终是匮乏的医疗保健系统。美国人已经将其称为“管理式医疗”。这就是为什么卫生政策分析师必须明确价值观在政策制定中的作用至关重要，尤其是涉及“价值中立”经济学的投入时。任何临床有效性政策的性质将取决于其设计和实施中所采用的成本效益的理解。鉴于如今成本效益通常是根据卫生经济学家的标准来定义的，关于临床有效性含义的争论是卫生经济学在试图掌控国民医疗服务体系过程中的一个重大进展。
