评估英国医保决策人制定的白内障手术临床阈值政策。
Evaluation of clinical threshold policies for cataract surgery among English commissioners.
机构信息
Department of Primary Care and Public Health, Imperial College, London.
出版信息
J Health Serv Res Policy. 2012 Oct;17(4):241-7. doi: 10.1258/jhsrp.2012.012023. Epub 2012 Sep 11.
OBJECTIVES
To ascertain if access to cataract surgery is being restricted in England and to describe any explicit threshold criteria.
METHODS
A survey of 151 local commissioners to explore their cataract surgery policy. A literature review identified research evidence about thresholds for cataract surgery. A checklist was devised and applied to the policies supplied by commissioners.
RESULTS
Almost half (71/151) of commissioners were restricting access to surgery and this included patients with some capacity to benefit. There was wide variation in the scope and content of the 67 policies which were available for review. Almost all (92%) commissioners use criteria that do not reflect guidance or research evidence.
CONCLUSIONS
Patients who could benefit from cataract surgery are being excluded by some commissioners. Variations in policy between commissioners results in inequalities in access.
目的
确定在英格兰是否限制了白内障手术的机会，并描述任何明确的阈值标准。
方法
对 151 名地方专员进行调查，以探讨他们的白内障手术政策。文献综述确定了有关白内障手术阈值的研究证据。设计了一份清单，并将其应用于专员提供的政策。
结果
几乎一半（71/151）的专员正在限制手术机会，这包括一些有能力受益的患者。可用审查的 67 项政策在范围和内容上存在很大差异。几乎所有（92％）的专员使用的标准都不反映指导或研究证据。
结论
一些专员将那些可以从白内障手术中受益的患者排除在外。专员之间政策的差异导致获得机会的不平等。
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