The George Institute for Global Health, University of New South Wales.
School of Public Health, The University of Sydney, New South Wales.
Aust N Z J Public Health. 2018 Apr;42(2):200-206. doi: 10.1111/1753-6405.12748. Epub 2017 Dec 13.
In the context of growing financial pressures on health budgets, cost-effective prevention strategies are needed to address the burden from non-communicable disease in Australia. We explored how decision makers use economic evidence to inform such investment and how such evidence generated can more effectively meet the needs of end users.
Thematic analysis of in-depth interviews with 15 high level stakeholders (Treasury, state health departments and the insurance industry), supplemented by documentary analysis.
Types of prevention approaches and economic evidence relevant to decision makers differed by organisational perspective. Capacity building in understanding economic evaluations and research evidence that addresses the differing criteria for investment used by different organisations is needed. The task of determining investment priorities in disease prevention comes with significant challenges including ideological barriers, delayed outcome measures, and implementation uncertainties. Conclusions and Implications for public health: Promoting the greater use of economic evidence in prevention requires more work on two fronts: tailoring the methods used by economists to better match the organisational imperatives of end users; and promoting greater consideration of broader societal and health sector perspectives among end users. This will require significant infrastructure development, monitoring and evaluation, stronger national leadership and a greater emphasis on evidence coproduction.
在卫生预算面临日益增长的财政压力的背景下，需要采取具有成本效益的预防策略来应对澳大利亚非传染性疾病的负担。本研究旨在探讨决策者如何利用经济证据来为这类投资提供信息，以及如何更有效地生成此类证据以满足最终用户的需求。
对 15 名高级利益相关者（财政部、州卫生部门和保险行业）进行深入访谈的主题分析，并辅以文献分析。
不同组织视角下的预防方法和经济证据的类型不同。需要加强决策者对经济评估和研究证据的理解，这些证据应考虑到不同组织用于投资的不同标准。确定疾病预防投资重点的任务面临着重大挑战，包括思想障碍、延迟的结果衡量指标和实施的不确定性。
要促进在预防中更多地使用经济证据，需要在两个方面开展更多工作：调整经济学家使用的方法，使其更好地符合最终用户的组织要求；促进最终用户更多地考虑更广泛的社会和卫生部门的观点。这将需要大量的基础设施发展、监测和评估、更强有力的国家领导以及更加注重证据的共同生产。
