Wasem J, Hessel F, Kerim-Sade C
Lehrstuhl für Allgemeine BWL und Gesundheitsmanagement, Universität Greifswald.
Psychiatr Prax. 2001 Jul;28 Suppl 1:S12-20. doi: 10.1055/s-2001-15382.
Because of scarcity of resources, diagnostic and therapeutic procedures in medicine increasingly have to be examined not only with regard to effectiveness but also with regard to cost-effectiveness, which means with regard to the relation between resources used and resulting outcome (however this outcome is measured). Primarily, this is true for treatment methods for one and the same medical condition. However, economists also consider to evaluate medical interventions across heterogeneous medical conditions, in order to rank them with regard to their cost-effectiveness. Using quality-adjusted life-years (QALYs) as outcome variable, all medical interventions examined can be ranked in QALY-League-Tables, which could serve as a basis for resource allocation decisions by health policy makers or other payers. However, there are methodological as well as ethical objections with such an approach.
由于资源稀缺，医学中的诊断和治疗程序越来越需要不仅从有效性方面进行审视，还要从成本效益方面进行考量，这意味着要考虑所用资源与所产生结果之间的关系（无论结果如何衡量）。首先，对于同一种医疗状况的治疗方法来说确实如此。然而，经济学家也考虑对不同的医疗状况下的医疗干预措施进行评估，以便根据其成本效益对它们进行排名。将质量调整生命年（QALYs）用作结果变量，所有被研究的医疗干预措施都可以在QALY排行榜中进行排名，这可以作为卫生政策制定者或其他支付方进行资源分配决策的依据。然而，这种方法存在方法学以及伦理学方面的反对意见。
