Asaria Miqdad, Griffin Susan, Cookson Richard
Centre for Health Economics, University of York, York, UK (MA, SG, RC).
Med Decis Making. 2016 Jan;36(1):8-19. doi: 10.1177/0272989X15583266. Epub 2015 Apr 23.
Distributional cost-effectiveness analysis (DCEA) is a framework for incorporating health inequality concerns into the economic evaluation of health sector interventions. In this tutorial, we describe the technical details of how to conduct DCEA, using an illustrative example comparing alternative ways of implementing the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). The 2 key stages in DCEA are 1) modeling social distributions of health associated with different interventions, and 2) evaluating social distributions of health with respect to the dual objectives of improving total population health and reducing unfair health inequality. As well as describing the technical methods used, we also identify the data requirements and the social value judgments that have to be made. Finally, we demonstrate the use of sensitivity analyses to explore the impacts of alternative modeling assumptions and social value judgments.
分布成本效益分析（DCEA）是一个将健康不平等问题纳入卫生部门干预措施经济评估的框架。在本教程中，我们通过一个比较实施国民医疗服务体系（NHS）肠癌筛查计划（BCSP）的不同方式的示例，描述了如何进行DCEA的技术细节。DCEA的两个关键阶段是：1）对与不同干预措施相关的健康社会分布进行建模，以及2）根据改善总体人群健康和减少不公平健康不平等这两个双重目标，评估健康的社会分布。除了描述所使用的技术方法外，我们还确定了数据要求以及必须做出的社会价值判断。最后，我们展示了如何使用敏感性分析来探索替代建模假设和社会价值判断的影响。
