Wester Gry, Bringedal Berit
1Department of Global Public Health and Primary Care,University of Bergen,Norway.
2The Institute for Studies of the Medical Profession,Oslo,Norway.
Health Econ Policy Law. 2018 Apr;13(2):118-136. doi: 10.1017/S1744133117000020. Epub 2017 Mar 21.
Different countries have adopted different strategies for tackling the challenge of allocating scarce health care resources fairly. Norway is one of the countries that has pioneered the effort to resolve priority setting by using a core set of priority-setting criteria. While the criteria themselves have been subject to extensive debate and numerous revisions, the question of how the criteria have been applied in practice has received less attention. In this paper, we examine how the criteria feature in the decisions and justifications of the Norwegian National Council for Priority Setting in Health Care, which has played an active role in deliberating about health care provision and coverage in Norway. We conducted a comprehensive document analysis, looking at the Council's decisions about health care allocation as well as the reasons they had provided to justify their decisions. We found that although the Council often made use of the official priority-setting criteria, they did so in an unsystematic and inconsistent manner.
不同国家采取了不同策略来应对公平分配稀缺医疗资源这一挑战。挪威是率先通过使用一套核心的优先排序标准来解决优先级设定问题的国家之一。虽然这些标准本身一直受到广泛辩论和多次修订，但这些标准在实践中是如何应用的问题却较少受到关注。在本文中，我们研究了这些标准在挪威医疗保健优先排序国家委员会的决策和理由阐述中是如何体现的，该委员会在挪威医疗保健提供和覆盖范围的审议中发挥了积极作用。我们进行了全面的文件分析，审视了该委员会关于医疗资源分配的决策以及他们为证明其决策合理性而提供的理由。我们发现，尽管该委员会经常使用官方的优先排序标准，但使用方式却不系统且不一致。
