Eddama Oya, Coast Joanna
National Perinatal Epidemiology Unit, University of Oxford, Old Road, Headington, Oxford OX3 7LF, UK.
Health Policy. 2008 May;86(2-3):129-41. doi: 10.1016/j.healthpol.2007.11.010. Epub 2008 Jan 14.
In view of resource scarcity, decisions have to be made on the optimal allocation of resources and one possible option in health care is economic evaluation. Little is known, however, about the use of economic evaluation. The objectives of this review were to assimilate the empirical evidence on this topic, discuss the main findings, and explore the possible need for further work needed in this area.
A total of 40 studies were included in the review from a range of countries. A systematic search strategy was used and data from papers were extracted in a systematic way.
Pharmacists and clinicians in the US are the most frequently sampled group and postal surveys was the most commonly used method. Despite some positive findings, in most cases there appear to be obstacles to the extensive use of economic evaluation in decision-making. Obstacles can be linked to three factors: (1) institutional and political; (2) cultural; (3) methodological factors associated with economic evaluation itself.
There has clearly been an increase in the use of economic evaluation over time, especially in the UK, whereas the US appears to have a deep rooted disfavour of the approach. However, there is still little known about the exact influence of economic evaluation at the local level. Whilst work conducted to date has been valuable in providing information about use and barriers to use, further qualitative work is needed to enrich and explain some of the findings from this review.
鉴于资源稀缺，必须对资源的最优分配做出决策，而卫生保健领域的一个可能选择是经济评估。然而，对于经济评估的使用情况却知之甚少。本综述的目的是收集关于该主题的实证证据，讨论主要发现，并探讨该领域可能需要进一步开展的工作。
该综述纳入了来自一系列国家的40项研究。采用了系统的检索策略，并以系统的方式提取了论文中的数据。
美国的药剂师和临床医生是最常被抽样的群体，邮寄调查是最常用的方法。尽管有一些积极的发现，但在大多数情况下，经济评估在决策中广泛应用似乎存在障碍。障碍可与三个因素相关：（1）制度和政治因素；（2）文化因素；（3）与经济评估本身相关的方法学因素。
随着时间的推移，经济评估的使用显然有所增加，尤其是在英国，而美国似乎对这种方法根深蒂固地不感兴趣。然而，对于经济评估在地方层面的确切影响仍知之甚少。虽然迄今为止开展的工作在提供关于使用情况和使用障碍的信息方面很有价值，但仍需要进一步的定性研究来丰富和解释本综述的一些发现。
