Catalá-López Ferrán, García-Altés Anna
División de Farmacoepidemiología y Farmacovigilancia, Agencia Española de Medicamentos y Productos Sanitarios, Ministerio de Sanidad y Política Social, Madrid.
Rev Esp Salud Publica. 2010 Jul-Aug;84(4):353-69. doi: 10.1590/s1135-57272010000400002.
Economic evaluation has been promoted as a tool to guide decision-making processes regarding healthcare resources' allocation and in the adoption of healthcare technologies. We analyzed the evolution and the main characteristics of economic evaluations of healthcare interventions done during the period 1983-2008 in Spain.
Observational descriptive study. We performed a systematic review in the main bibliographic databases (PubMed/ MEDLINE, SCOPUS, ISI Web of Knowledge, CRD, IME, IBECS) and manually through Internet in journals and public reports. There were predefined inclusion and exclusion criteria, and a set of variables to analyze the characteristics of the selected reports.
In total, 477 studies fulfilled the inclusion criteria. Some of the studies characteristics were: cost-effectiveness analysis (62.5%), decision analysis techniques (34.0%), healthcare system perspective (42.1%), therapeutic interventions (70.0%) and non explicit financing (44.0%). The geographical distribution for Spanish regions of the first authors was: Catalonia (29.3%), Community of Madrid (23.7%), Andalusia (6,7%) and Region of Valencia (6.3%). A total of 50.9% of the principal authors were employed at hospital centers. The most common disease conditions were: cardiovascular diseases (15.7%), infectious and parasitic diseases (15.3%) and malignant neoplasms (13.2%). A total of 82.2 % of the reports provided recommendations for decision making.
An increasing number of studies was observed. Identified reports combined heterogeneity in the quality of the information brought with regard to analysis methods, data sources, type of interventions, or disease conditions. It is suggested to do more efforts for improving the quantity and quality of reports in public health interventions.
经济评估已被推崇为一种工具，用于指导有关医疗资源分配和医疗技术采用的决策过程。我们分析了1983年至2008年期间西班牙所做的医疗干预经济评估的演变及主要特征。
观察性描述研究。我们在主要文献数据库（PubMed/MEDLINE、SCOPUS、ISI Web of Knowledge、CRD、IME、IBECS）中进行了系统综述，并通过互联网在期刊和公共报告中手动检索。有预定义的纳入和排除标准，以及一组用于分析所选报告特征的变量。
共有477项研究符合纳入标准。部分研究特征如下：成本效益分析（62.5%）、决策分析技术（34.0%）、医疗系统视角（42.1%）、治疗性干预（70.0%）以及未明确融资（44.0%）。第一作者所在西班牙地区的地理分布为：加泰罗尼亚（29.3%）；马德里自治区（23.7%）；安达卢西亚（6.7%）；巴伦西亚自治区（6.3%）。共有50.9%的主要作者受雇于医院中心。最常见的疾病状况为：心血管疾病（15.7%）、传染病和寄生虫病（15.3%）以及恶性肿瘤（13.2%）。共有82.2%的报告提供了决策建议。
观察到研究数量不断增加。所识别的报告在分析方法、数据来源、干预类型或疾病状况等方面所提供信息的质量存在异质性。建议在公共卫生干预方面做出更多努力，以提高报告的数量和质量。
