Bunker J P, Frazier H S, Mosteller F
King's College, London.
Milbank Q. 1994;72(2):225-58.
The impact of medical care on the quality and length of life of the population has been poorly documented. The rapid growth of evidence of efficacy of therapy for individual medical conditions now offers the opportunity to create an inventory of benefits. A method for creating such an inventory is described, as is its application to a selection of condition-treatment pairs, chosen for their high incidence of prevalence, their serious outcomes, and the demonstrated efficacy of their treatment. An aggregate effect of medical care on life expectancy is found to be roughly five years during this century, with a further potential of two years. Although there is no overall index of quality of life analogous to life expectancy, our inventory demonstrates the enormous burden of pain, suffering, and dysfunction that afflicts the population for which medical care can provide a large measure of relief.
医疗保健对人口生活质量和寿命的影响鲜有文献记载。目前,针对个体医疗状况的治疗效果证据迅速增加,这为创建一份益处清单提供了契机。本文描述了创建此类清单的方法,以及该方法在一系列疾病 - 治疗组合中的应用,这些组合因其高发病率、严重后果以及已证实的治疗效果而被选中。研究发现,在本世纪,医疗保健对预期寿命的总体影响约为五年,还有进一步提高两年的潜力。虽然目前尚无类似于预期寿命的总体生活质量指标,但我们的清单表明,疼痛、痛苦和功能障碍给人们带来了巨大负担,而医疗保健能够在很大程度上缓解这些问题。