Begley Charles E, Baker Gus A, Beghi Ettore, Butler James, Chisholm Daniel, Langfitt John T, Levy Pierre, Pachlatko Christoph, Wiebe Samuel, Donaldson Karen Lee
School of Public Health, University of Texas 77030, USA.
Epilepsia. 2007 May;48(5):990-1001. doi: 10.1111/j.1528-1167.2007.00981.x. Epub 2007 Feb 23.
The International League Against Epilepsy (ILAE) Commission on Healthcare Policy in consultation with the World Health Organization (WHO) examined the applicability and usefulness of various measures for monitoring epilepsy healthcare services and systems across countries. The goal is to provide planners and policymakers with tools to analyze the impact of healthcare services and systems and evaluate efforts to improve performance.
Commission members conducted a systematic literature review and consulted with experts to assess the nature, strengths, and limitations of the treatment gap and resource availability measures that are currently used to assess the adequacy of epilepsy care. We also conducted a pilot study to determine the feasibility and applicability of using new measures to assess epilepsy care developed by the WHO including Disability-Adjusted Life Years (DALYs), responsiveness, and financial fairness.
The existing measures that are frequently used to assess the adequacy of epilepsy care focus on structural or process factors whose relationship to outcomes are indirect and may vary across regions. The WHO measures are conceptually superior because of their breadth and connection to articulated and agreed upon outcomes for health systems. However, the WHO measures require data that are not readily available in developing countries and most developed countries as well.
The epilepsy field should consider adopting the WHO measures in country assessments of epilepsy burden and healthcare performance whenever data permit. Efforts should be made to develop the data elements to estimate the measures.
国际抗癫痫联盟（ILAE）医疗保健政策委员会与世界卫生组织（WHO）协商，研究了各国监测癫痫医疗服务和系统的各种措施的适用性和实用性。目标是为规划者和政策制定者提供工具，以分析医疗服务和系统的影响，并评估改善绩效的努力。
委员会成员进行了系统的文献综述，并咨询了专家，以评估目前用于评估癫痫护理充分性的治疗差距和资源可用性措施的性质、优势和局限性。我们还进行了一项试点研究，以确定使用世界卫生组织制定的评估癫痫护理的新措施的可行性和适用性，包括伤残调整生命年（DALYs）、反应性和财务公平性。
经常用于评估癫痫护理充分性的现有措施侧重于结构或过程因素，这些因素与结果的关系是间接的，并且可能因地区而异。世界卫生组织的措施在概念上更具优势，因为它们的广度以及与明确和商定的卫生系统结果的联系。然而，世界卫生组织的措施需要的数据在发展中国家以及大多数发达国家也不容易获得。
只要数据允许，癫痫领域应考虑在国家癫痫负担和医疗保健绩效评估中采用世界卫生组织的措施。应努力开发数据元素以估计这些措施。
