Coast Joanna
Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK.
Expert Rev Pharmacoecon Outcomes Res. 2014 Aug;14(4):473-82. doi: 10.1586/14737167.2014.914436. Epub 2014 May 2.
Economic evaluation of end of life care is increasingly expected from both research funders and those making decisions about the use of health and social care resources. There are, however, difficulties in applying the currently established evaluative methods to end of life. These are partly associated with the sensitivity of the topic and the feasibility of data collection but also, more fundamentally, a lack of agreement about the terms in which such care should be evaluated. This paper examines different theoretical perspectives from which economic evaluation of end of life care could be conducted, and argues for the application of a capability approach focusing on the opportunity for a good death. It then examines challenges with taking forward such an approach, including defining, measuring and valuing appropriate outcomes. It concludes that such an approach is viable, and explores how it might be taken forward to assist with resource allocation decisions.
研究资助者以及那些对健康和社会护理资源使用做出决策的人，越来越期望对临终关怀进行经济评估。然而，将目前既定的评估方法应用于临终关怀存在困难。这些困难部分与该主题的敏感性和数据收集的可行性有关，但更根本的是，对于应以何种术语来评估此类护理缺乏共识。本文审视了可用于开展临终关怀经济评估的不同理论视角，并主张应用一种聚焦于善终机会的能力方法。接着，本文探讨了推进这种方法所面临的挑战，包括界定、衡量和评估适当的结果。结论是这种方法是可行的，并探讨了如何推进它以协助资源分配决策。
