Raspe Heiner
Gastwissenschaftler am Institut für Ethik, Geschichte und Theorie der Medizin, Münster, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2018 Feb;130:8-12. doi: 10.1016/j.zefq.2017.08.002. Epub 2017 Sep 19.
Since about 2005 VbHC has become a prominent movement on the border between population medicine and health economics. The "value" it is aiming at is defined as health care "outcomes per dollar spent". The text focuses on the work of two prominent proponents: M.E. Porter and J.A.M. Gray. It considers background and central elements of VbHC and discusses similarities and differences between the two authors. Especially the differences raise questions that will hopefully play a role in the German discussion that is still in its infancy. Three complex topics seem to be particularly relevant: the relationship between VbHC and evidence-based health care, the question of who is to benefit from VbHC (total, diseased, patient population?), and the role of moral values especially the value of solidarity with the severely ill and socially deprived.
自2005年左右起,以价值为基础的医疗保健(VbHC)已成为人口医学与卫生经济学交界处的一项重要运动。它所追求的“价值”被定义为“每花费一美元所获得的医疗保健结果”。本文聚焦于两位重要支持者的工作:M.E. 波特(M.E. Porter)和J.A.M. 格雷(J.A.M. Gray)。文章探讨了VbHC的背景和核心要素,并讨论了两位作者观点的异同。尤其是这些差异引发了一些问题,有望在仍处于起步阶段的德国相关讨论中发挥作用。三个复杂的主题似乎尤为相关:VbHC与循证医疗保健之间的关系、谁将从VbHC中受益的问题(全体人群、患病者、患者群体?),以及道德价值观的作用,特别是对重症患者和社会弱势群体的团结价值。