Hollinghurst S, Shaw A, Thompson E A
Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol, 25 Belgrave Road, Clifton, Bristol BS8 2AA, United Kingdom.
Complement Ther Med. 2008 Feb;16(1):47-51. doi: 10.1016/j.ctim.2007.10.001. Epub 2007 Nov 19.
Complementary and alternative medicine (CAM) is growing in popularity among patients, for an increasing range of conditions. However, current provision of CAM in the National Health Service in the UK is limited, patchy and disparate, which results in considerable inequity and patient unease. This has led to an escalation in the debate about the role of CAM within the NHS. Lack of evidence about the cost effectiveness of CAM therapies compared with other forms of care is often cited as the main reason for the reluctance of funders to integrate CAM into mainstream service provision. Cost-effectiveness relies on evidence about costs and benefits. Cost data are relatively straightforward to collect but it has proved difficult to value the complete package of benefits offered by CAM, likely to be both process and outcome based, in a way that can be compared with alternatives. Stated preference discrete choice modelling (SPDCM), a method of healthcare evaluation growing in popularity, uses information about patient preferences to identify the important characteristics of an intervention or method of delivering care and how patients value these. SPDCM is a method that could be used to evaluate the 'added value' provided by CAM and thus supply evidence on cost-effectiveness that policy makers could use in configuring service provision.
补充和替代医学（CAM）在患者中越来越受欢迎，适用于越来越多的病症。然而，目前英国国民医疗服务体系（NHS）中补充和替代医学的提供是有限的、零散的且各不相同的，这导致了相当大的不公平性以及患者的不安。这引发了关于补充和替代医学在国民医疗服务体系中作用的争论升级。与其他形式的护理相比，补充和替代医学疗法缺乏成本效益的证据，这常常被认为是资助者不愿将补充和替代医学纳入主流服务提供的主要原因。成本效益依赖于关于成本和效益的证据。成本数据相对容易收集，但事实证明，难以以一种可与其他选择进行比较的方式，对补充和替代医学所提供的可能基于过程和结果的整套效益进行评估。陈述偏好离散选择模型（SPDCM）是一种越来越受欢迎的医疗保健评估方法，它利用有关患者偏好的信息来确定干预措施或护理提供方式的重要特征，以及患者如何重视这些特征。陈述偏好离散选择模型是一种可用于评估补充和替代医学所提供的“附加值”的方法，从而提供政策制定者在配置服务提供时可使用的成本效益证据。
