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英国背景下的经验调整生命年与关键医疗资源分配:哪位患者应该存活?

Experience adjusted life years and critical medical allocations within the British context: which patient should live?

作者信息

Pruski Michal

机构信息

Manchester Metropolitan University, All Saints Building, Manchester, M15 6BH, UK.

Critical Care Laboratory, Critical Care Directorate, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK.

出版信息

Med Health Care Philos. 2018 Dec;21(4):561-568. doi: 10.1007/s11019-018-9830-5.

Abstract

Medical resource allocation is a controversial topic, because in the end it prioritises some peoples' medical problems over those of others. This is less controversial when there is a clear clinical reason for such a prioritisation, but when such a reason is not available people might perceive it as deeming certain individuals more important than others. This article looks at the role of social utility in medical resource allocation, in a situation where the clinical outcome would be identical if either person received the treatment. This situation is explored with a focus on the United Kingdom, but its conclusions have wider applications to any system where healthcare is tax-payer funded. The article proposes an experience adjusted life years system, and discusses its strengths and weaknesses.

摘要

医疗资源分配是一个有争议的话题,因为最终它将一些人的医疗问题置于其他人之上。当这种优先排序有明确的临床理由时,争议较小,但当没有这样的理由时,人们可能会认为这是将某些个体看得比其他个体更重要。本文探讨了社会效用在医疗资源分配中的作用,即在两个人接受治疗临床结果相同的情况下。本文以英国为重点探讨了这种情况,但其结论在任何由纳税人资助医疗保健的系统中都有更广泛的应用。本文提出了一种经验调整生命年系统,并讨论了其优缺点。

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