Ho Van Hoa, Giguère Yves, Reinharz Daniel
Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, QC G1V 5C3, Canada.
Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Laval University, Quebec City, QC G1V 5C3, Canada.
Int J Neonatal Screen. 2024 May 13;10(2):36. doi: 10.3390/ijns10020036.
Health systems in high-resource countries recognize the importance of making decisions about the services offered to the population based on scientific evidence. Producing this evidence is especially challenging in areas such as newborn care where the frequency of conditions is rare. However, methodological advances in the field of economic evaluation could change how this evidence is used in decision-making. This study aimed to investigate how decision-makers in the Canadian province of Quebec perceive the value of recent advances in economic evaluations for perinatal studies and how these advances might affect the offer of neonatal interventions in the public health care system. A qualitative study was conducted. A total of 10 policymakers were interviewed. A neo-institutional conceptual framework highlighting three dimensions, structure, power, and interpretive schemes, was used for data collection and analyses. Structural factors, interpretative schemes, and power management between the groups concerned concur to ensure that providing services to newborns is not hindered by the difficulty of producing evidence. They also ensure that the decisions regarding which disease to screen for take into consideration the specificity of neonatology, in particular, the social value given to children not captured by available evidence.
资源丰富国家的卫生系统认识到，基于科学证据为民众提供的服务做出决策非常重要。在新生儿护理等疾病发生率较低的领域，提供此类证据尤其具有挑战性。然而，经济评估领域的方法进步可能会改变此类证据在决策中的使用方式。本研究旨在调查加拿大魁北克省的决策者如何看待围产期研究经济评估的最新进展的价值，以及这些进展可能如何影响公共卫生保健系统中新生儿干预措施的提供。开展了一项定性研究。共采访了10名政策制定者。一个突出结构、权力和解释方案三个维度的新制度概念框架被用于数据收集和分析。相关群体之间的结构因素、解释方案和权力管理共同协作，以确保为新生儿提供服务不会因证据生成困难而受阻。它们还确保在决定筛查哪种疾病时，会考虑到新生儿学的特殊性，特别是现有证据未涵盖的给予儿童的社会价值。
