Ratcliffe Julie, Lancsar Emily, Walker Ruth, Gu Yuanyuan
Institute for Choice, Business School, University of South Australia, Adelaide, Australia.
Centre for Health Economics, Monash University, Melbourne, Australia.
Health Policy. 2017 Jun;121(6):653-662. doi: 10.1016/j.healthpol.2017.03.003. Epub 2017 Mar 16.
Health care policy makers internationally are increasingly expressing commitment to consultation with, and incorporation of, the views of the general public into the formulation of health policy and the process of setting health care priorities. In practice, however, there are relatively few opportunities for the general public to be involved in health care decision-making. In making resource allocation decisions, funders, tasked with managing scarce health care resources, are often faced with difficult decisions in balancing efficiency with equity considerations. A mixed methods (qualitative and quantitative) approach incorporating focus group discussions and a ranking exercise was utilised to develop a comprehensive list of potential criteria for setting priorities in health care formulated from the perspective of members of the general public in Australia. A strong level of congruence was found in terms of the rankings of the key criteria with the size of the health gain, clinical effectiveness, and the ability to provide quality of life improvements identified consistently as the three most important criteria for prioritising the funding of an intervention. Findings from this study will be incorporated into a novel DCE framework to explore how decision makers and members of the general public prioritize and trade off different types of health gain and to quantify the weights attached to specific efficiency and equity criteria in the priority setting process.
国际上的医疗保健政策制定者越来越多地表示致力于在制定卫生政策和确定医疗保健优先事项的过程中与公众进行协商并纳入公众的意见。然而，在实践中，公众参与医疗保健决策的机会相对较少。在做出资源分配决策时，负责管理稀缺医疗保健资源的资助者在平衡效率与公平考量方面往往面临艰难的决策。采用了一种结合焦点小组讨论和排序活动的混合方法（定性和定量），从澳大利亚普通民众的角度制定了一份全面的医疗保健优先事项设定潜在标准清单。研究发现，关键标准的排名与健康收益规模、临床效果以及改善生活质量的能力高度一致，这三项标准一直被确定为确定干预措施资金优先顺序的最重要标准。本研究的结果将被纳入一个新颖的离散选择实验（DCE）框架，以探讨决策者和公众如何对不同类型的健康收益进行优先排序和权衡，并量化在优先事项设定过程中赋予特定效率和公平标准的权重。
