Jiang Shan, Li Boyang, Parkinson Bonny, Li Shunping, Gu Yuanyuan
Macquarie University Centre for the Health Economy, Macquarie Business School and Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China.
Glob Health Res Policy. 2025 Apr 16;10(1):17. doi: 10.1186/s41256-025-00415-z.
Health equity is a growing concern for policymakers across the globe. Conventional cost-effectiveness analysis (CEA), commonly used in evaluating health interventions, primarily focuses on the average and aggregate health outcomes in the targeted population, neglecting the distributional impacts on health equity. This gap calls for approaches that can quantify the impact of intervention of interest on health equity to support decision-making. Distributional Cost-Effectiveness Analysis (DCEA) offers a framework to assess the distributional impacts of health interventions. Based on DCEA, aggregate DCEA (A-DCEA) was proposed as a practical and simplified alternative to DCEA. Unlike full DCEA, which requires detailed subgroup data, A-DCEA utilizes aggregated data, making it accessible and feasible for broader use. In this commentary, we discuss the rationale for A-DCEA, outline the steps for its implementation, and highlight its applicability. The purpose of this article is to introduce A-DCEA as a pragmatic and accessible tool for evaluating the equity implications of healthcare interventions. A-DCEA can inform policymakers by incorporating equity considerations into healthcare decision-making, particularly when conducting a full DCEA is impractical due to data limitation. A-DCEA provides a valuable and accessible method for evaluating the distributional impact of interventions, promoting health equity in decision-making. Its adoption can lead to more informed health policy that considers health inequities as well as the efficient use of resources.
健康公平性日益受到全球政策制定者的关注。传统的成本效益分析（CEA）常用于评估健康干预措施，主要关注目标人群的平均和总体健康结果，而忽视了对健康公平性的分布影响。这一差距需要能够量化感兴趣的干预措施对健康公平性影响的方法来支持决策。分布成本效益分析（DCEA）提供了一个评估健康干预措施分布影响的框架。基于DCEA，总分布成本效益分析（A-DCEA）被提出作为DCEA的一种实用且简化的替代方法。与需要详细亚组数据的完整DCEA不同，A-DCEA利用汇总数据，使其更易于获取且更广泛适用。在这篇评论中，我们讨论了A-DCEA的原理，概述了其实施步骤，并强调了其适用性。本文的目的是介绍A-DCEA，将其作为一种实用且易于使用的工具，用于评估医疗保健干预措施的公平性影响。A-DCEA可以通过将公平性考虑纳入医疗保健决策为政策制定者提供信息，特别是在由于数据限制而无法进行完整DCEA的情况下。A-DCEA为评估干预措施的分布影响提供了一种有价值且易于使用的方法，在决策中促进健康公平性。采用A-DCEA可以带来更明智的卫生政策，该政策既考虑健康不平等问题，又能有效利用资源。
