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证据为基础的协商过程在医保目录设计中的道德和社会价值——评“证据为基础的协商过程在医保目录设计中的应用(第二部分:实用指南)”

Moral and Social Values in Evidence-Informed Deliberative Processes for Health Benefit Package Design Comment on "Evidence-Informed Deliberative Processes for Health Benefit Package Design - Part II: A Practical Guide".

机构信息

Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.

出版信息

Int J Health Policy Manag. 2023;12:7480. doi: 10.34172/ijhpm.2022.7480. Epub 2022 Dec 28.

Abstract

An evidence-informed deliberative process (EDP) is defined as "a practical and stepwise approach for health technology assessment (HTA) bodies to enhance legitimate health benefit package design based on deliberation between stakeholders to identify, reflect and learn about the meaning and importance of values, informed by evidence on these values." In this commentary, I discuss some considerations for EDPs that arise from acknowledging the difference between social and moral values. First, the best practices for implementing EDPs may differ depending on whether the approach is grounded in moral versus social values. Second, the goals of deliberation may differ when focused on moral versus social values. I conclude by offering some considerations for future research to support the use of EDPs in practice, including the need to assess how different approaches to appraisal (eg, more quantitative versus qualitative) impact perceptions of the value of deliberation itself.

摘要

循证审议过程(EDP)被定义为“一种实用的、循序渐进的方法,供卫生技术评估(HTA)机构在利益攸关方之间进行审议,根据这些价值观的证据,识别、反映和了解价值观的意义和重要性,从而增强合法的卫生效益套餐设计。” 在这篇评论中,我讨论了一些需要考虑的问题,这些问题源于承认社会价值观和道德价值观之间的差异。首先,实施 EDP 的最佳实践可能因方法基于道德价值观还是社会价值观而有所不同。其次,当专注于道德价值观还是社会价值观时,审议的目标可能会有所不同。最后,我提出了一些未来研究的考虑因素,以支持 EDP 在实践中的使用,包括评估不同评估方法(例如,更多定量方法与定性方法)如何影响对审议本身价值的看法。

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Personal responsibility within health policy: unethical and ineffective.个人在卫生政策中的责任:不道德且无效。
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