van Baal Pieter
Erasmus Universiteit Rotterdam, instituut Beleid & Management Gezondheidszorg, Rotterdam.
Ned Tijdschr Geneeskd. 2015;159:A8680.
Scientists and politicians repeatedly call for more investment in prevention. Besides improving public health, this would reduce health care spending. This article discusses two mechanisms that are relevant to the debate regarding the efficiency of prevention. The first mechanism concerns the additional demand for health care as a result of increased life expectancy. The second mechanism concerns the impact that improvements in curative care have on the consequences of prevention. Both mechanisms show that prevention and curative care cannot be considered separately. Consequently, decisions on investments in preventive and curative care should ideally be based on the same decision-making framework. An effective deployment of prevention and care will benefit from economic evaluations that give as full a picture as possible of both the costs and benefits of new interventions.
科学家和政治家们一再呼吁加大对预防工作的投入。这不仅能改善公众健康,还能减少医疗保健支出。本文讨论了与预防效率辩论相关的两种机制。第一种机制涉及预期寿命增加导致的对医疗保健的额外需求。第二种机制涉及治疗护理的改善对预防效果的影响。这两种机制都表明,预防和治疗护理不能分开考虑。因此,关于预防和治疗护理投资的决策理想情况下应基于相同的决策框架。有效开展预防和护理工作将受益于经济评估,这些评估应尽可能全面地呈现新干预措施的成本和效益情况。