Health Human Resources Research Center, Department of Health Economics, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Health Evidence, Radboud University Medical Centre, Nijmegen, the Netherlands.
Int J Technol Assess Health Care. 2023 Jun 19;39(1):e37. doi: 10.1017/S0266462323000302.
Integrating social values into health technology assessment processes is an important component of proper healthcare priority setting. This study aims to identify social values related to healthcare priority setting in Iran.
A scoping review was conducted on original studies that investigating social values in the healthcare system in Iran. The databases of PubMed, EMBASE, and EBSCO were searched with no restrictions on time and language. The reported criteria were clustered using Sham's framework of social value analysis in health policy.
Twenty-one studies published between 2008 and 2022 met the inclusion criteria. Fourteen of the included studies followed a quantitative approach with different methods to identify criteria, and the remaining seven studies used a qualitative approach. A total of fifty-five criteria were extracted and clustered into necessity, quality, sustainability, and process categories. Only six studies found criteria that were related to processes. Only three studies used public opinions as a source of value identification and eleven studies investigated the weight of criteria. None of the included studies explored the interdependency of the criteria.
Evidence suggests that several criteria other than cost per health unit also need to be considered in healthcare priority setting. Previous studies have paid little attention to the social values that underlie priority setting and policy-making processes. To reach consensus on social values related to healthcare priority setting, future researches need to involve broader stakeholders' perspectives as a valuable source of social values in a fair process.
将社会价值观纳入卫生技术评估过程是正确医疗保健优先排序的重要组成部分。本研究旨在确定与伊朗医疗保健优先排序相关的社会价值观。
对调查伊朗医疗体系中社会价值观的原始研究进行了范围综述。使用 PubMed、EMBASE 和 EBSCO 数据库进行搜索,不限制时间和语言。使用 Sham 的健康政策社会价值分析框架对报告的标准进行聚类。
2008 年至 2022 年间发表的 21 项研究符合纳入标准。其中 14 项纳入研究采用了定量方法,采用不同方法确定标准,其余 7 项研究采用了定性方法。共提取了 55 个标准,并分为必要性、质量、可持续性和过程类别。只有 6 项研究发现了与过程相关的标准。只有 3 项研究使用公众意见作为价值识别的来源,11 项研究调查了标准的权重。没有一项纳入的研究探讨了标准的相互依存性。
有证据表明,在医疗保健优先排序中除了每单位健康的成本外,还需要考虑其他几个标准。先前的研究很少关注优先排序和决策过程背后的社会价值观。为了就与医疗保健优先排序相关的社会价值观达成共识,未来的研究需要将更广泛的利益相关者的观点作为公平过程中社会价值观的有价值来源。