Decimoni Tassia Cristina, Leandro Roseli, Rozman Luciana Martins, Craig Dawn, Iglesias Cynthia P, Novaes Hillegonda Maria Dutilh, de Soárez Patrícia Coelho
Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Institute of Health and Society, Newcastle University, Newcastle, United Kingdom.
Front Public Health. 2018 Feb 28;6:52. doi: 10.3389/fpubh.2018.00052. eCollection 2018.
Brazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs) have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting.
We systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and ); citation indexes (SCOPUS, Web of Science), and . Partial and full HEEs published between 1980 and 2013 that referred to a Brazilian setting were considered for inclusion.
In total, 535 studies were included in the review, 36.8% of these were considered to be full HEE. The category of healthcare technologies more frequently assessed were procedures (34.8%) and drugs (28.8%) which main objective was treatment (72.1%). Forty-four percent of the studies reported their funding source and 36% reported a conflict of interest. Overall, the full HEE quality of reporting was satisfactory. But some items were generally poorly reported and significant improvement is required: (1) methods used to estimate healthcare resource use quantities and unit costs, (2) methods used to estimate utility values, (3) sources of funding, and (4) conflicts of interest.
A steady number of HEE have been published in Brazil since 1980. To improve their contribution to inform national healthcare policy efforts need to be made to enhance the quality of reporting of HEEs and promote improvements in the way HEEs are designed, implemented (i.e., using sound methods for HEEs) and reported.
巴西一直试图利用经济评估来支持医疗保健决策过程。虽然已经进行了一些卫生经济评估(HEE),但尚无研究对巴西卫生经济评估的质量进行系统评价。本系统评价的目的是概述卫生经济评估研究的现状,并评估在巴西开展的已发表卫生经济评估研究的数量、特征和报告质量。
我们系统检索了电子数据库(MEDLINE、EMBASE、拉丁美洲和加勒比地区卫生科学文献数据库、科学电子图书馆在线、英国国家卫生服务体系经济评估数据库、卫生技术评估数据库、Bireme以及……)、引文索引(SCOPUS、科学引文索引)以及……。纳入1980年至2013年间发表的提及巴西背景的部分和完整卫生经济评估。
本评价共纳入535项研究,其中36.8%被认为是完整的卫生经济评估。评估频率较高的医疗保健技术类别是手术(34.8%)和药物(28.8%),其主要目的是治疗(72.1%)。44%的研究报告了其资金来源,36%报告了利益冲突。总体而言,完整卫生经济评估的报告质量令人满意。但一些项目的报告普遍较差,需要显著改进:(1)用于估计医疗保健资源使用量和单位成本的方法,(2)用于估计效用值的方法,(3)资金来源,以及(4)利益冲突。
自1980年以来,巴西已发表了数量稳定的卫生经济评估。为提高其对国家医疗保健政策的参考作用,需要努力提高卫生经济评估报告的质量,并促进卫生经济评估在设计、实施(即采用合理的卫生经济评估方法)和报告方式上的改进。