Division of Health and Social Care Research, King's College School of Medicine, London, UK.
J Health Organ Manag. 2012;26(3):363-73. doi: 10.1108/14777261211239007.
The purpose of this paper is to provide an overview of the organisational and procedural arrangements for priority setting in England and Wales. It describes the role of social values in the decision-making process.
DESIGN/METHODOLOGY/APPROACH: The processes and content of decisions made by the National Institute for Health and Clinical Excellence are analysed using the framework developed by Clark and Weale for identifying social values in health priority-setting.
While countries are seeking to achieve similar outcomes from their health prioritisation processes, each country has established different systems that reflect the social and legal framework underpinning their health systems. England is somewhat unique in being explicit about assessing "value for money" and using formal cost-effectiveness in developing policy.
ORIGINALITY/VALUE: Many countries are now considering the use of formal health economic methodologies to assess the value and prioritise health care interventions. However there is increasing recognition of the importance of values other than efficiency (cost effectiveness) in making acceptable decisions. This is manifest in the range of potential new approaches being developed including multiple criteria decision analysis.
本文旨在概述英格兰和威尔士制定优先事项的组织和程序安排。它描述了社会价值观在决策过程中的作用。
设计/方法/方法：使用克拉克和韦尔 (Clark and Weale) 为确定健康优先事项中的社会价值观而制定的框架，分析了国家卫生与临床优化研究所 (National Institute for Health and Clinical Excellence) 做出的决策的过程和内容。
尽管各国都在努力从其卫生重点制定过程中实现类似的结果，但每个国家都建立了不同的系统，反映了其卫生系统所依据的社会和法律框架。英格兰在明确评估“物有所值”并在制定政策时使用正式成本效益方面有些独特。
创新性/价值：许多国家现在都在考虑使用正式的健康经济方法来评估医疗保健干预措施的价值和优先级。然而，人们越来越认识到，在做出可接受的决策时，除了效率（成本效益）之外，其他价值观也很重要。这体现在正在开发的一系列潜在新方法中，包括多标准决策分析。
