Instituto do Coracao do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
Heart Failure Clinic, Department of Cardiology, Maastricht University Medical Center, Maastricht, Netherlands.
Medicine (Baltimore). 2023 Oct 20;102(42):e35614. doi: 10.1097/MD.0000000000035614.
Cost-effectiveness analysis has long been practiced; registries date back to the United States of America War Department in 1886. In addition, everyone does intuitive cost-effectiveness analyses in their daily lives. In routine medical care, health economic assessment becomes increasingly important due to progressively limited resources, rising demands, population increases, and continuous therapeutic innovations. The health economic assessment must analyze the outcomes and costs of actions and technologies as objectively as possible to guarantee efficient assessment of novel interventions for Public Health Policy. In other words, it is necessary to determine how much society or patients are willing to or able to pay for novel interventions compared with existing alternatives, given the available resources. In addition, increased cost may displace other health care services already provided in case of fixed budget health care systems. To conduct such analyses, researchers must use standard methodologies and interpretations in light of regional characteristics according to social and economic determinants as well as clinical practice. Such an approach may be essential for transforming the current healthcare system to a value-based model. In this narrative review, concepts of the importance of and some approaches to health economic evaluation in clinical practice will be discussed.
成本效益分析由来已久，最早可追溯到 1886 年美国陆军部的记录。此外，每个人在日常生活中都会进行直观的成本效益分析。由于资源日益有限、需求不断增加、人口增长和持续的治疗创新，医疗保健中的经济评估变得越来越重要。为了对公共卫生政策的新干预措施进行有效的评估，必须尽可能客观地分析行动和技术的结果和成本。换句话说，必须根据现有资源，确定社会或患者相对于现有替代方案愿意或能够为新干预措施支付多少费用。此外，在固定预算的医疗保健系统中，增加的成本可能会取代已经提供的其他医疗保健服务。为了进行此类分析，研究人员必须根据社会和经济决定因素以及临床实践，使用标准方法和解释。对于将当前的医疗保健系统转变为基于价值的模式，这种方法可能是必不可少的。在这篇叙述性综述中，将讨论临床实践中健康经济评估的重要性和一些方法的概念。
