BODE3 Programme, University of Otago Wellington, New Zealand.
BODE3 Programme, University of Otago Wellington, New Zealand; Population Interventions, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
N Z Med J. 2021 Mar 12;134(1531):101-113.
In this viewpoint, we suggest that policymakers should prioritise health interventions by using evidence around health gain, impact on equity, health-system costs and cost-effectiveness. We take the example of the new cancer control agency in New Zealand, Te Aho o Te Kahu, and argue that its decision-making can now be informed by many methodologically compatible epidemiological and health economic analyses. These analyses span primary prevention of cancer (eg, tobacco control, dietary and physical activity interventions and HPV vaccination), cancer screening, cancer treatment and palliative care. The largest health gain and cost-savings from the available modelling work for New Zealand are seen in nutrition and tobacco control interventions in particular. Many of these interventions have potentially greater per capita health gain for Māori than non-Māori and are also found to be cost saving for the health sector. In summary, appropriate prioritisation of interventions can potentially both maximise health benefits as well as making best use of government funding of the health system.
在这个观点中,我们建议政策制定者应该通过利用健康收益、对公平的影响、卫生系统成本和成本效益方面的证据来优先考虑卫生干预措施。我们以新西兰新成立的癌症控制机构 Te Aho o Te Kahu 为例,认为其决策现在可以参考许多方法上兼容的流行病学和健康经济学分析。这些分析涵盖癌症的一级预防(例如,烟草控制、饮食和体育活动干预以及 HPV 疫苗接种)、癌症筛查、癌症治疗和姑息治疗。从新西兰现有的建模工作中获得的最大健康收益和成本节约见于营养和烟草控制干预措施,特别是在这方面。这些干预措施中的许多措施对毛利人比非毛利人具有更大的人均健康收益,并且也被发现对卫生部门具有成本节约效果。总之,对干预措施的适当优先排序可以最大限度地提高健康效益,同时充分利用政府对卫生系统的资金投入。