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了解韩国对医疗设备的偏好:一项离散选择实验。

Eliciting preferences for medical devices in South Korea: A discrete choice experiment.

作者信息

Lee Hye-Jae, Bae Eun-Young

机构信息

Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, South Korea.

School of Pharmacy, Gyeongsang National University, Jinju, South Korea; Institute of Pharmacy, Gyeongsang National University, Jinju, South Korea.

出版信息

Health Policy. 2017 Mar;121(3):243-249. doi: 10.1016/j.healthpol.2017.01.002. Epub 2017 Jan 10.

Abstract

This study aims to identify the attributes that contribute to the value of medical devices and quantify the relative importance of them using a discrete choice experiment. Based on a literature review and expert consultation, seven attributes and their levels were identified-severity of disease (2), availability of substitutes (2), improvement in procedure (3), improvement in clinical outcomes (2), increase in survival (2), improvement in quality of life (3), and cost (4). Among 576 hypothetical profiles, optimal choice sets with 20 choices were developed and experts experienced in health technology assessment and reimbursement decision making in South Korea were surveyed. A total of 102 respondents participated in the survey. The results of the random-effect probit model showed that among the seven attributes, six, except for improvement in procedure, had a significant impact on respondents' choices on medical devices. Respondents were willing to pay the highest amount for devices that provided substantial improvements in quality of life, followed by increased survival, improved clinical outcome, treatment without substitutes, and technology for treating severe diseases. The findings of this experiment will inform decision-makers of the relative importance of the criteria and help them in reimbursement decision making of medical devices.

摘要

本研究旨在确定有助于医疗设备价值的属性,并使用离散选择实验对其相对重要性进行量化。基于文献综述和专家咨询,确定了七个属性及其水平——疾病严重程度(2个水平)、替代品可用性(2个水平)、手术改进(3个水平)、临床结果改善(2个水平)、生存率提高(2个水平)、生活质量改善(3个水平)以及成本(4个水平)。在576个假设配置文件中,开发了包含20个选择的最优选择集,并对韩国卫生技术评估和报销决策方面的专家进行了调查。共有102名受访者参与了调查。随机效应概率模型的结果表明,在这七个属性中,除手术改进外,其他六个属性对受访者对医疗设备的选择有显著影响。受访者愿意为能大幅改善生活质量的设备支付最高金额,其次是提高生存率、改善临床结果、无替代品的治疗以及治疗严重疾病的技术。本实验的结果将告知决策者这些标准的相对重要性,并帮助他们进行医疗设备的报销决策。

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