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为公共卫生战略与决策制定政策分析——谢菲尔德酒精政策模型框架

Developing policy analytics for public health strategy and decisions-the Sheffield alcohol policy model framework.

作者信息

Brennan Alan, Meier Petra, Purshouse Robin, Rafia Rachid, Meng Yang, Hill-Macmanus Daniel

机构信息

School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, Regent Street, Sheffield, S1 4DA UK.

出版信息

Ann Oper Res. 2016;236(1):149-176. doi: 10.1007/s10479-013-1451-z. Epub 2013 Oct 8.

Abstract

This paper sets out the development of a methodological framework for detailed evaluation of public health strategies for alcohol harm reduction to meet UK policy-makers needs. Alcohol is known to cause substantial harms, and controlling its affordability and availability are effective policy options. Analysis and synthesis of a variety of public and commercial data sources is needed to evaluate impact on consumers, health services, crime, employers and industry, so a sound evaluation of impact is important. We discuss the iterative process to engage with stakeholders, identify evidence/data and develop analytic approaches and produce a final model structure. We set out a series of steps in modelling impact including: classification and definition of population subgroups of interest, identification and definition of harms and outcomes for inclusion, classification of modifiable components of risk and their baseline values, specification of the baseline position on policy variables especially prices, estimating effects of changing policy variables on risk factors including price elasticities, quantifying risk functions relating risk factors to harms including 47 health conditions, crimes, absenteeism and unemployment, and monetary valuation. The most difficult model structuring decisions are described, as well as the final results framework used to provide decision support to national level policymakers in the UK. In the discussion we explore issues around the relationship between modelling and policy debates, valuation and scope, limitations of evidence/data, how the framework can be adapted to other countries and decisions. We reflect on the approach taken and outline ongoing plans for further development.

摘要

本文阐述了一个方法框架的发展情况,该框架用于详细评估减少酒精危害的公共卫生策略,以满足英国政策制定者的需求。众所周知,酒精会造成重大危害,控制其可承受性和可得性是有效的政策选择。需要对各种公共和商业数据源进行分析和综合,以评估对消费者、医疗服务、犯罪、雇主和行业的影响,因此对影响进行合理评估很重要。我们讨论了与利益相关者互动、识别证据/数据、开发分析方法并生成最终模型结构的迭代过程。我们列出了一系列影响建模步骤,包括:对感兴趣的人群亚组进行分类和定义,识别和定义纳入的危害和结果,对风险的可改变组成部分及其基线值进行分类,明确政策变量尤其是价格的基线位置,估计政策变量变化对风险因素(包括价格弹性)的影响,量化将风险因素与危害(包括47种健康状况、犯罪、旷工和失业)相关联的风险函数,以及货币估值。描述了最困难的模型构建决策,以及用于为英国国家层面政策制定者提供决策支持的最终结果框架。在讨论中,我们探讨了围绕建模与政策辩论之间的关系、估值与范围、证据/数据的局限性、该框架如何适用于其他国家以及决策等问题。我们反思了所采用的方法,并概述了进一步发展的持续计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a17/4710054/d3fdf1748689/10479_2013_1451_Fig1_HTML.jpg

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