医疗保险预算影响分析研究质量的评价体系构建
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篇名: 医疗保险预算影响分析研究质量的评价体系构建
TITLE: Construction of the Evaluation System of the Research Quality of Medical Insurance Budget Impact Analysis
摘要: 目的:构建评价医保药品谈判中医保预算影响分析(BIA)研究质量的评价体系,为医保等相关部门提供切实可行的评价工具。方法:基于国际药物经济学与结果研究协会(ISPOR)和加拿大、波兰、美国等国家的BIA指导性文件及相关实证文献,结合专家访谈法,确定医保谈判BIA材料相关要素(包括关键要素和辅助要素),并运用层次分析法确定各要素的权重,构建计算BIA研究质量评价总分的量表及体系。结果:关键要素有目标人群、市场情景和治疗成本三大数据块,包含人口总数、新药情景市场份额、治疗方案成本等共计14个关键要素;根据符合程度分别赋值0~3分,并以归一化后的最低分作为BIA研究质量的基础分。辅助要素有标题&摘要、研究背景、分析框架、结果呈现和其他五大数据块,包括标题、摘要、研究角度、研究时限等23个辅助要素;根据要素是否存在质量等级差异分为A类与B类,分别采用等级评分(0~4分)和0/1评分(是为1分,否为0分),并以此计算后相加即得BIA研究质量的附加分。根据基础分和附加分乘以不同权重(分别为0.67和0.33)再相加可计算出BIA研究质量评价总分体系。结论:本研究成功构建了一种全新的BIA质量评价体系,可用于评价医保药品谈判所提交的BIA研究质量。
ABSTRACT: OBJECTIVE:To construc t the evaluation system of the research quality of medical insurance budget impact analysis (BIA),and to provide feasible evaluation tool for related departments as medical insurance department. METHODS :Based on BIA guidance documents and relevant empirical literatures of ISPOR ,Canada,Poland,the United States and other countries , combined with expert interview ,the relevant elements of medical insurance negotiation BIA material were confirmed (including key elements and adjuctive elements ). The scale and system was established to calculate total score of BIA research quality evaluation. RESULTS :Key elements included three data blocks as target population ,market situation and treatment cost ,involving 14 key elements such as total population ,new drug scenario market share ,treatment cost ,etc.. According to the degree of compliance,0-3 points were assigned and the lowest score after normalization was taken as the basic score of BIA research quality. The adjunctive elements included five data blocks as title & abstract ,research background ,analysis framework ,result presentation and other ,including 23 adjunctive elements such as title ,abstract,research angle ,research time limit ,etc.. According to whether there is quality grade difference ,the elements were divided into type A and type B ;the grade score (0-4 points)and 0/1 score(1 point for yes and 0 point for no )were used respectively ,and the additional score of BIA research quality was obtained after calculation and addition. According to the addition of different weights (0.67 and 0.33)of basic score and additional score ,the total score system of BIA research quality evaluation could be calculated. CONCLUSIONS :This study successfully constructed a new BIA quality evaluation system ,which can be used for the quality evaluation of BIA research submitted by medical insurance drug negotiation.
期刊: 2020年第31卷第21期
作者: 王敏娇,李灿,杜怿,柳鹏程,曹春烨,曹阳
AUTHORS: WANG Minjiao,LI Can,DU Yi,LIU Pengcheng,CAO Chunye,CAO Yang
关键字: 医疗保险;预算影响分析;评价体系;关键要素;辅助要素
KEYWORDS: Medical insurance ;Budget impact analysis ;Evaluation system ;Key element ;Adjunctive element
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