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经济评估的酒精预防干预措施:证据是否充分?方法学挑战的综述。

Economic evaluations of alcohol prevention interventions: Is the evidence sufficient? A review of methodological challenges.

机构信息

Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon-Tyne, NE2 4AX, UK; Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle upon-Tyne, UK.

Centre for Public Policy and Health, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University, Queen's Campus, Stockton-on-Tees, TS17 6BH, UK; Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle upon-Tyne, UK.

出版信息

Health Policy. 2017 Dec;121(12):1249-1262. doi: 10.1016/j.healthpol.2017.10.003. Epub 2017 Oct 27.

Abstract

Public health interventions have unique characteristics compared to health technologies, which present additional challenges for economic evaluation (EE). High quality EEs that are able to address the particular methodological challenges are important for public health decision-makers. In England, they are even more pertinent given the transition of public health responsibilities in 2013 from the National Health Service to local government authorities where new agents are shaping policy decisions. Addressing alcohol misuse is a globally prioritised public health issue. This article provides a systematic review of EE and priority-setting studies for interventions to prevent and reduce alcohol misuse published internationally over the past decade (2006-2016). This review appraises the EE and priority-setting evidence to establish whether it is sufficient to meet the informational needs of public health decision-makers. 619 studies were identified via database searches. 7 additional studies were identified via hand searching journals, grey literature and reference lists. 27 met inclusion criteria. Methods identified included cost-utility analysis (18), cost-effectiveness analysis (6), cost-benefit analysis (CBA) (1), cost-consequence analysis (CCA) (1) and return-on-investment (1). The review identified a lack of consideration of methodological challenges associated with evaluating public health interventions and limited use of methods such as CBA and CCA which have been recommended as potentially useful for EE in public health. No studies using other specific priority-setting tools were identified.

摘要

公共卫生干预措施与卫生技术相比具有独特的特点,这给经济评估(EE)带来了额外的挑战。能够解决特定方法学挑战的高质量 EE 对公共卫生决策者非常重要。在英国,鉴于 2013 年公共卫生责任从国民保健制度向地方政府当局转移,新机构正在制定政策决策,这种情况更加相关。解决酗酒问题是全球优先的公共卫生问题。本文对过去十年(2006-2016 年)在国际上发表的预防和减少酗酒干预措施的 EE 和优先排序研究进行了系统评价。本综述评估了 EE 和优先排序证据,以确定其是否足以满足公共卫生决策者的信息需求。通过数据库搜索确定了 619 项研究。通过手检期刊、灰色文献和参考文献列表确定了另外 7 项研究。符合纳入标准的有 27 项。确定的方法包括成本效用分析(18)、成本效果分析(6)、成本效益分析(CBA)(1)、成本效益分析(CCA)(1)和投资回报(1)。该综述发现,评估公共卫生干预措施时,没有考虑到与方法相关的挑战,并且很少使用 CBA 和 CCA 等方法,这些方法被认为对公共卫生中的 EE 可能有用。没有发现使用其他特定优先排序工具的研究。

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