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关于健康技术再评估现状的系统评价:对韩国的启示

A systematic review on current status of health technology reassessment: insights for South Korea.

作者信息

Seo Hyun-Ju, Park Ji Jeong, Lee Seon Heui

机构信息

Department of Nursing, College of Medicine, Chosun University, Gwangju, Korea.

National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.

出版信息

Health Res Policy Syst. 2016 Nov 11;14(1):82. doi: 10.1186/s12961-016-0152-x.

Abstract

BACKGROUND

To systematically investigate the current status and methodology of health technology reassessment (HTR) in various countries to draw insights for the healthcare system in South Korea.

METHODS

A systematic literature search was conducted on the articles published between January 2000 and February 2015 on Medline, EMBASE, the Cochrane Library, CINAHL, and PubMed. The titles and abstracts of retrieved records were screened and selected by two independent reviewers. Data related to HTR were extracted using a pre-standardised form. The review was conducted using narrative synthesis to understand and summarise the HTR process and policies.

RESULTS

Forty five studies, conducted in seven countries, including the United Kingdom, Australia, Canada, Spain, Sweden, Denmark, and the United States of America, fulfilled the inclusion criteria. Informed by the literature review, and complemented by informant interviews, we focused on HTR activities in four jurisdictions: the United Kingdom, Canada, Australia, and Spain. There were similarities in the HTR processes, namely the use of existing health technology assessment agencies, reassessment candidate technology identification and priority setting, stakeholder involvement, support for reimbursement coverage, and implementation strategies. Considering the findings of the systematic review in the context of the domestic healthcare environment in Korea, an appropriate HTR model was developed. This model included four stages, those of identification, prioritisation, reassessment and decision.

CONCLUSIONS

Disinvestment and reinvestment through the HTR was used to increase the efficiency and quality of care to help patients receive optimal treatment. Based on the lessons learnt from other countries' experiences, Korea should make efforts to establish an HTR process that optimises the National Healthcare Insurance system through revision of the existing Medical Service Act.

摘要

背景

系统调查各国卫生技术再评估(HTR)的现状和方法,为韩国医疗体系提供参考。

方法

对2000年1月至2015年2月期间发表在Medline、EMBASE、Cochrane图书馆、CINAHL和PubMed上的文章进行系统文献检索。由两名独立评审员筛选和选择检索记录的标题和摘要。使用预先标准化的表格提取与HTR相关的数据。采用叙述性综合方法进行综述,以了解和总结HTR过程及政策。

结果

在包括英国、澳大利亚、加拿大、西班牙、瑞典、丹麦和美国在内的七个国家进行的45项研究符合纳入标准。在文献综述的基础上,并通过 informant 访谈进行补充,我们重点关注了四个司法管辖区的HTR活动:英国、加拿大、澳大利亚和西班牙。HTR过程存在相似之处,即利用现有的卫生技术评估机构、重新评估候选技术的识别和优先级设定、利益相关者的参与、对报销覆盖范围的支持以及实施策略。结合韩国国内医疗环境下的系统评价结果,开发了一个合适的HTR模型。该模型包括四个阶段,即识别、优先级确定、重新评估和决策。

结论

通过HTR进行撤资和再投资,以提高医疗效率和质量,帮助患者获得最佳治疗。基于从其他国家经验中吸取的教训,韩国应努力通过修订现行《医疗服务法》来建立一个优化国家医疗保险体系的HTR流程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f5e/5106773/66b94fb90ac3/12961_2016_152_Fig1_HTML.jpg

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