Programs for Assessment of Technology in Health (PATH) Research Institute, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada; Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Best Pract Res Clin Gastroenterol. 2013 Dec;27(6):831-44. doi: 10.1016/j.bpg.2013.08.016. Epub 2013 Sep 26.
In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation.
在新的医疗服务需求不断增加和新资源受到重大限制的背景下,卫生经济学和卫生技术评估(HTA)等学科越来越被视为明确的循证框架,以帮助做出艰难的医疗保健准入和报销决策。卫生经济学是经济学的一个分支,关注卫生保健资源的有效分配,本质上试图在可用资源的基础上最大化社会的健康效益。HTA 是一个更广泛的领域,借鉴了多个学科,但严重依赖卫生经济学和经济评估的工具。传统上,卫生经济学和经济评估在政治(宏观)和地方(中观)决策层面得到广泛应用,并且即使在为告知个人临床决策(微观层面)提供信息方面也发挥了重要作用。本文的目的是向读者介绍卫生经济学,并讨论其与一线临床医生的相关性。特别是,本文的内容将有助于临床医生理解经济学与其医疗实践之间的联系,以及临床决策如何反映卫生保健资源分配。