School of Public Health, University of Queensland, Queensland, Australia.
Institute of Health Metrics and Evaluation, University of Washington, Seattle, Washington.
Int J Eat Disord. 2017 Mar;50(3):315-319. doi: 10.1002/eat.22688. Epub 2017 Feb 21.
Worldwide, the demand for healthcare exceeds what individuals and governments are able to afford. Priority setting is therefore inevitable, and mental health services have often been given low priority in the decision-making process. Drawing on established economic criteria, and specifically the work of Philip Musgrove, key factors which influence government decision-making about health priorities are reviewed. These factors include the size of the health burden, the availability of cost-effective interventions to reduce the burden, whether private markets can provide the necessary treatment efficiently, whether there are "catastrophic costs" incurred in accessing treatment, whether negative externalities arise from not providing care, and if the "rule of rescue" applies. Beyond setting priorities for resource allocation, governments also become involved where there is a need for regulation to maintain quality in the delivery of healthcare. By providing field-specific examples for each factor, we illustrate how advocates in the eating disorder field may use evidence to inform government policy about resource allocation and regulation in support of individuals with an eating disorder.
在全球范围内，对医疗保健的需求超过了个人和政府的承受能力。因此，进行优先排序是不可避免的，而精神卫生服务在决策过程中往往被置于次要地位。本文借鉴了既定的经济标准，特别是菲利普·马斯格雷夫（Philip Musgrove）的研究成果，对影响政府制定卫生优先事项决策的关键因素进行了回顾。这些因素包括卫生负担的大小、是否有具有成本效益的干预措施来减轻负担、私人市场是否能够有效地提供必要的治疗、获得治疗是否存在“灾难性成本”、是否存在不提供护理产生的负外部性，以及“救援规则”是否适用。除了为资源分配设定优先级外，政府还需要进行监管，以维持医疗保健服务的质量。通过为每个因素提供具体领域的例子，我们说明了饮食障碍领域的倡导者如何利用证据为政府的资源分配和监管政策提供信息，以支持患有饮食障碍的个人。
