King's Fund, London, UK.
Health Econ Policy Law. 2010 Oct;5(4):397-409. doi: 10.1017/S1744133109990302. Epub 2009 Dec 22.
Recent authors have proposed that waiting times for elective treatment should be reduced to the point where the costs of doing so exceed the benefits. This paper considers how this criterion could be put into effect. Taking benefits first it argues that these could be estimated in three different ways - social cost benefit, clinical and user valuation - that would not necessarily produce consistent results and hence a choice has to be made between them. It then considers the costs of reducing waits and argues, citing relevant evidence, that these may range widely according to whether or not reductions can be achieved through simple management measures or whether more long-term capacity is required. It concludes therefore that the apparently simple criterion proposed for defining the point where waiting times are optimal is hard to establish. Choice of criterion must be made in the light of the overall values that a given health care system is intended to promote.
最近有作者提出，择期治疗的等候时间应该缩短到这样一个点，即这样做的成本超过了收益。本文考虑了如何实施这一标准。首先考虑收益，认为这些收益可以通过三种不同的方式来估计——社会成本效益、临床和用户评估——这些方法不一定会产生一致的结果，因此必须在它们之间做出选择。然后考虑减少等待时间的成本，并援引相关证据认为，这些成本可能相差很大，具体取决于减少等待时间是否可以通过简单的管理措施实现，或者是否需要更多的长期能力。因此，该标准旨在定义等待时间最佳的点，但这一标准看似简单，却难以确定。标准的选择必须根据特定医疗保健系统旨在促进的整体价值来做出。
