Division of Health and Social Research, King's College London, London, UK.
J Health Organ Manag. 2012;26(3):407-21. doi: 10.1108/14777261211239043.
The purpose of this paper is to demonstrate that the social values framework developed by Clark and Weale could be applied to publicly available data and to explore the concordance between the framework values and those present in the statements of decision-making protocols of Health Technology Assessment Agencies.
DESIGN/METHODOLOGY/APPROACH: The web sites of the National Institute for Health and Clinical Excellence (NICE); the All Wales Strategy Medicines Group; and the Scottish Medicines Consortium were searched for references to social value statements and assessed according to the social values framework.
The framework was easy to apply and demonstrated that it is possible to find statements of operational expression of a range of social values in the description of the decision protocols used by the public agencies. Most of the framework's values find some expression in the statements of the decision protocols, but there are differences. For example, the All Wales Group, when discussing clinical effectiveness, explicitly refers to an assessment via "pathways of care" in a way that neither of the other two do. The value of autonomy is explicitly mentioned by NICE but not by the other two, whereas the value of solidarity (a value most typically associated with European social insurance systems) finds only indirect expression in the guidance notes of all.
The paper provides further information that will be useful in revising the framework in preparation for its role in future data collection.
ORIGINALITY/VALUE: This is the initial step in developing a social values instrument that will support health policy decisions. While there are other check lists of social values, this is the first time that an approach to creating a framework is being tested empirically.
本文旨在展示克拉克(Clark)和韦尔(Weale)提出的社会价值框架可应用于公开数据,并探讨该框架的价值观与健康技术评估机构决策协议中的陈述所体现的价值观之间的一致性。
设计/方法/途径:检索了国家卫生与临床优化研究所(NICE)、威尔士全民医疗服务战略药品组(All Wales Strategy Medicines Group)和苏格兰药品联合会(Scottish Medicines Consortium)的网站,查找有关社会价值陈述的参考文献,并根据社会价值框架进行评估。
该框架易于应用,表明可以在公共机构使用的决策协议描述中找到一系列社会价值的操作表达陈述。框架的大多数价值观在决策协议的陈述中都有一定程度的体现,但存在差异。例如,威尔士全民医疗服务战略药品组在讨论临床疗效时,明确提到通过“护理途径”进行评估,而其他两个机构没有这样做。自主价值观由 NICE 明确提及,但其他两个机构没有提及,而团结价值观(与欧洲社会保险制度最相关的价值观之一)仅在所有指南说明中找到间接表达。
本文提供了进一步的信息,这将有助于在修订框架时提供参考,为未来的数据收集做好准备。
原创性/价值:这是开发社会价值工具以支持健康政策决策的初始步骤。虽然有其他社会价值检查表,但这是首次对创建框架的方法进行实证测试。