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如果目标是全民健康覆盖,那么在一揽子计划设计中,制度化是公平确定优先次序的重要因素 述评“基于证据的健康福利包设计审议程序 - 第二部分:实用指南”。

Institutionalisation Is a Vital Element for Fairness of Priority Setting in the Package Design if the Target is Universal Health Coverage Comment on "Evidence-Informed Deliberative Processes for Health Benefits Package Design - Part II: A Practical Guide".

机构信息

Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran.

Ministry of Health, Federal Government of Somalia, Mogadishu, Somalia.

出版信息

Int J Health Policy Manag. 2023;12:7544. doi: 10.34172/ijhpm.2022.7544. Epub 2022 Dec 12.

Abstract

The evidence-informed deliberative processes (EDPs) guide provides a practical framework for fair priority setting of the health benefits package (HBP) that countries can reasonably use. The steps presented in the EDPs are applicable for prioritising health services in designing HBP and are consistent with practical experience in countries. However, institutionalisation must be considered an element of fairness in the priority-setting process if the aim is to reach broader goals of a health system, such as universal health coverage (UHC). Otherwise, the EDPs for priority setting might not be integrated into the formal health system or impactful, resulting in a waste of time and resources, which is unfair. Institutionalisation means formalising the desired change as an embedded and integrated system so that the change lasts over time. For the institutionalisation of EPDs, four stages are suggested, which are (1) establishing a supportive legal framework, (2) designating governance and institutional structure, (3) stipulating the EDPs processes and (4) individual and institutional capacity building.

摘要

循证决策程序(EDPs)指南为国家合理使用的医保福利包(HBP)公平优先排序提供了实用框架。EDPs 中提出的步骤适用于在设计 HBP 时对卫生服务进行优先排序,并且与各国的实践经验一致。然而,如果目标是实现更广泛的卫生系统目标,如全民健康覆盖(UHC),那么制度化必须被视为优先排序过程中的公平要素。否则,优先排序的 EDP 可能不会被纳入正式的卫生系统或产生影响,从而导致时间和资源的浪费,这是不公平的。制度化是指将所需的变革正式化并纳入一个嵌入式和综合系统,以便变革能够持续下去。为了实现 EDP 的制度化,建议分四个阶段进行,即(1)建立支持性法律框架,(2)指定治理和机构结构,(3)规定 EDP 流程,以及(4)个人和机构能力建设。

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