Banta H David, de Wit G Ardine
University of Maastricht, Maastricht, The Netherlands.
Annu Rev Public Health. 2008;29:383-97. doi: 10.1146/annurev.publhealth.29.020907.090808.
Cost-effectiveness analysis as an aid to decision making has been increasingly publicized and discussed during the past two to three decades. However, the total body of cost-effectiveness analyses in health care is actually rather small, and high-quality studies are rather rare. Furthermore, the applications of economic analysis to health policy have been hampered by a number of problems, including those that are methodological and contextual. We consider a number of areas of public health policy but pay special attention to a growing area of inquiry and application: the overall coverage of health services. Cost-effectiveness analysis has played a relatively small role in general coverage decisions, but in recent years, it has been applied increasingly to decisions concerning pharmaceutical coverage. We speculate on concerning reasons for this particular focus in cost-effectiveness analysis. Future progress will depend heavily on discussion and consensus building.
在过去二三十年里，成本效益分析作为决策辅助手段得到了越来越多的宣传和讨论。然而，医疗保健领域成本效益分析的总体数量实际上相当少，高质量的研究更是罕见。此外，经济分析在卫生政策中的应用受到了一些问题的阻碍，包括方法学和背景方面的问题。我们考虑了公共卫生政策的多个领域，但特别关注一个不断发展的研究和应用领域：卫生服务的总体覆盖范围。成本效益分析在一般覆盖范围决策中发挥的作用相对较小，但近年来，它越来越多地应用于药品覆盖范围的决策。我们推测了成本效益分析这一特定重点的相关原因。未来的进展将在很大程度上取决于讨论和共识的建立。
