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健康状态偏好方面的种族和族裔差异及其对成本效用分析的影响。

Racial and ethnic differences in preferences for health states and the implications for cost-utility analysis.

作者信息

Saalfrank Megan F, Wang Junling, Brown Lawrence M

机构信息

Department of Pharmaceutical Sciences, University of Tennessee College of Pharmacy, 847 Monroe Avenue, Room 205, Memphis, TN 38163, USA.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2009 Aug;9(4):365-73. doi: 10.1586/erp.09.27.

Abstract

AIMS

Cost-utility analysis is an economic evaluation technique that takes into consideration individual preferences for health outcomes. It is crucial to determine whether racial and ethnic groups differ in preferences for health states because then we need to determine which group's utility score should be used to conduct a cost-utility analysis that yields equitable results to all members of society.

METHODS

A PubMed search was conducted to identify the relevant studies.

RESULTS

There exists a potential to either undervalue or overvalue health states along racial and ethnic lines when population-based utility scores are used for clinical or policy decision-making. Some argue that if systematic racial and ethnic differences exist, then race/ethnicity-specific measures should be incorporated in the economic evaluations, at least for interventions targeted at the prevention and treatment of diseases which disproportionately affect minorities. Yet, others believe that there are troubling social and ethical implications to using subgroup health preferences as they also have the potential to disadvantage minorities.

CONCLUSIONS

Attention is required for the equity issues related to the utilizations of cost-utility analysis.

摘要

目的

成本效用分析是一种经济评估技术,它考虑了个体对健康结果的偏好。确定不同种族和族裔群体在健康状态偏好上是否存在差异至关重要,因为那样我们就需要确定应该使用哪个群体的效用分数来进行成本效用分析,从而为社会所有成员产生公平的结果。

方法

通过在PubMed上检索来识别相关研究。

结果

当基于人群的效用分数用于临床或政策决策时,存在沿种族和族裔界限低估或高估健康状态的可能性。一些人认为,如果存在系统性的种族和族裔差异,那么在经济评估中应纳入针对特定种族/族裔的措施,至少对于那些对少数群体影响尤为严重的疾病的预防和治疗干预措施而言。然而,另一些人认为,使用亚组健康偏好存在令人不安的社会和伦理问题,因为它们也有可能使少数群体处于不利地位。

结论

需要关注与成本效用分析应用相关的公平问题。

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