印度尼西亚的卫生经济评估：一项评估证据质量和对印度尼西亚卫生技术评估（HTA）指南遵循情况的系统评价
Health economic evaluations for Indonesia: a systematic review assessing evidence quality and adherence to the Indonesian Health Technology Assessment (HTA) Guideline.
作者信息
Chavarina Kinanti Khansa, Faradiba Dian, Sari Ella Nanda, Wang Yi, Teerawattananon Yot
机构信息
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Bangkok, Thailand.
出版信息
Lancet Reg Health Southeast Asia. 2023 Mar 31;13:100184. doi: 10.1016/j.lansea.2023.100184. eCollection 2023 Jun.
BACKGROUND
The Government of Indonesia implemented health technology assessment (HTA) to ensure quality and cost control in the National Health Insurance Program (/JKN). The current aim of the study was to improve the usefulness of future economic evaluation for resource allocation by appraising current methodology, reporting, and source of evidence quality of studies.
METHODS
The inclusion and exclusion criteria were applied to search for relevant studies using a systematic review. The methodology and reporting adherence were appraised according to Indonesia's HTA Guideline issued in 2017. The differences in adherence before and after the guideline dissemination were compared using Chi-square and Fisher's exact tests for methodology adherence wherever appropriate, and the Mann-Whitney test for reporting adherence. The source of evidence quality was assessed using evidence hierarchy. Two scenarios of the study start date and the guideline dissemination period were tested using sensitivity analyses.
FINDINGS
Eighty-four studies were obtained from PubMed, Embase, Ovid, and two local journals. Only two articles cited the guideline. No statistically significant difference (P > 0.05) was found between the pre-dissemination and post-dissemination period with respect to methodology adherence, except for outcome choice. Studies during the post-dissemination period showed a higher score for reporting which was statistically significant (P = 0.01). However, the sensitivity analyses revealed no statistically significant difference (P > 0.05) in methodology (except for modelling type, P = 0.03) and reporting adherence between the two periods.
INTERPRETATION
The guideline did not impact the methodology and reporting standard used in the included studies. Recommendations were provided to improve the usefulness of economic evaluations for Indonesia.
FUNDING
The Access and Delivery Partnership (ADP) hosted by the United Nations Development Programme (UNDP) and the Health Systems Research Institute (HSRI).
背景
印度尼西亚政府实施了卫生技术评估（HTA），以确保国家医疗保险计划（/JKN）中的质量和成本控制。本研究的当前目的是通过评估当前的方法、报告以及研究证据质量的来源，提高未来经济评估对资源分配的有用性。
方法
采用系统评价的方法，应用纳入和排除标准来检索相关研究。根据2017年发布的印度尼西亚HTA指南对方法和报告的依从性进行评估。在适当的情况下，使用卡方检验和费舍尔精确检验比较指南发布前后方法依从性的差异，使用曼-惠特尼检验比较报告依从性的差异。使用证据等级评估证据质量的来源。使用敏感性分析测试了研究开始日期和指南发布期的两种情景。
结果
从PubMed、Embase、Ovid和两家当地期刊中获得了84项研究。只有两篇文章引用了该指南。在方法依从性方面，除了结果选择外，在指南发布前和发布后期间未发现统计学上的显著差异（P>0.05）。在发布后期间的研究报告得分更高，具有统计学显著性（P=0.01）。然而，敏感性分析显示，在两个时期之间，方法（除建模类型外，P=0.03）和报告依从性方面没有统计学上的显著差异（P>0.05）。
解读
该指南并未影响纳入研究中使用的方法和报告标准。为提高印度尼西亚经济评估的有用性提供了建议。
资金来源
由联合国开发计划署（UNDP）和卫生系统研究所（HSRI）主办的获取与交付伙伴关系（ADP）。
Zotero 插件