Poley Marten J, Brouwer Werner B F, Busschbach Jan J V, Hazebroek Frans W J, Tibboel Dick, Rutten Frans F H, Molenaar Jan C
Department of Paediatric Surgery, Sophia Children's Hospital, Erasmus MC, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
Pediatr Surg Int. 2008 Feb;24(2):119-27. doi: 10.1007/s00383-007-2045-0. Epub 2007 Nov 6.
Mortality rates in neonatal surgery have dropped markedly, illustrating the enormous progress made. Yet, new questions have arisen. To mention one, health care budgets have tightened. It follows that the effects of medical interventions should be weighted against their costs. As evidence was particularly sparse, we set out to analyse cost-effectiveness of neonatal surgery. The purpose of this article is to summarise our findings and to review recent studies. Moreover, this article explains the relevance of cost-effectiveness analysis and explores how cost-effectiveness interacts with other determinants of health care priority setting. Our research revealed that treatments for two common diagnostic categories in neonatal surgery (congenital anorectal malformations and congenital diaphragmatic hernia) produce good cost-effectiveness. Other groups also published cost-effectiveness studies in the field of neonatal surgery, although their number is still small. Contemporaneously, the economic aspects of health care have captured the interest of policy makers. Importantly, this is not to say that there are no other factors playing a role in priority setting, foremost among which are ethical questions and arguments of equity. This article concludes that, according to present evidence, neonatal surgery yields good value for money and contributes to equity in health.
新生儿外科的死亡率已显著下降，这表明取得了巨大进展。然而，新的问题也随之出现。仅举一例，医疗保健预算已收紧。因此，医疗干预的效果应与其成本相权衡。由于证据特别稀少，我们着手分析新生儿外科的成本效益。本文的目的是总结我们的研究结果并回顾近期的研究。此外，本文解释了成本效益分析的相关性，并探讨了成本效益如何与医疗保健优先事项设定的其他决定因素相互作用。我们的研究表明，新生儿外科中两种常见诊断类型（先天性肛门直肠畸形和先天性膈疝）的治疗具有良好的成本效益。其他团队也发表了新生儿外科领域的成本效益研究，尽管数量仍然很少。与此同时，医疗保健的经济方面已引起政策制定者的关注。重要的是，这并不是说在优先事项设定中没有其他因素发挥作用，其中最主要的是伦理问题和公平性论点。本文得出结论，根据目前的证据，新生儿外科性价比高，并有助于实现健康公平。
