Mikhail O I, Swint J M, Casperson P R, Spitz M R
University of Texas Health Science Center, School of Public Health, Houston, USA.
J Public Health Manag Pract. 1997 May;3(3):37-42. doi: 10.1097/00124784-199705000-00009.
Curative services often have been judged by their perceived value, while preventive services have been held to a more rigorous standard of documentation. The dilemma for preventive services is not driven by evidence of their cost-ineffectiveness relative to curative services, but by the paucity of evidence of any type. The issues are whether preventive services of different types are perceived as having value, by what criteria these perceptions are measured, and by whom they are determined. We examine five key constituencies, the measures by which the value of prevention is judged, and the implications for the funding of prevention activities.
治疗服务常常依据其被感知到的价值来评判，而预防服务则需遵循更为严格的记录标准。预防服务面临的困境并非源于相对于治疗服务而言其成本效益缺乏证据，而是源于各类证据的匮乏。问题在于不同类型的预防服务是否被视为具有价值，依据何种标准来衡量这些认知，以及由谁来确定这些认知。我们考察了五个关键群体、评判预防价值的标准，以及对预防活动资金投入的影响。
