我国儿童治疗方案经济学评价的现状与不足
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篇名: 我国儿童治疗方案经济学评价的现状与不足
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摘要: 目的:为提高我国儿童治疗方案经济学评价研究水平提供参考。方法:通过检索2009年1月1日-2018年12月31日国内期刊发表的我国儿童治疗方案经济学研究相关文献,探索成本(包括时间范围、成本计算)与健康产出(包括结果指标、测量量表)测量的研究现状,并结合国内外相关文献,总结我国儿童治疗方案经济学评价在上述两方面存在的不足,提出相应的对策。结果与结论:最终纳入140篇相关文献。在成本测量方面,短期(≤1年)研究占比最高(109篇,77.86%),成本计算多未明确研究角度(125篇,89.29%),均未涉及儿童生产力成本,主要存在时间范围不明确、成本计算不完整(生产力缺失、隐形成本)等不足;在健康产出测量方面,103篇(73.57%)采用成本-效果分析的方法,23篇(16.43%)采用成本-效益分析的方法,仅有4篇(2.86%)涉及测量量表的使用,主要存在结果指标获取困难、儿童健康产出测量量表缺乏等不足。基于此,笔者建议在进行经济学评价研究前应严格按照相关要求,明确研究角度,制订统一、规范的成本测量方式,根据研究目的与疾病特征合理选择技术分析方法和健康产出指标,并根据不同年龄段患儿的生理、心理特征开发适宜的测量量表,同时,未来研究可以在报告儿童相关状况时报道其家庭成员的状况,以家庭为单位进行治疗方案的经济学评估。
ABSTRACT: OBJECTIVE: To provide reference for improving the economics evaluation studies for pediatric therapeutic regime in China. METHODS: By searching the literature published in domestic journals from Jan. 1st, 2009 to Dec. 31th, 2018, the current situation of the measurement of cost (including time range, cost calculation) and health output (including outcome indicators and measurement scales) were explored. Combined with relevant literature at home and abroad, the deficiencies of economics evaluation for pediatric therapeutic regime in terms of cost measurement and health outcome measurement were summarized in China, and the corresponding research prospects were put forward. RESULTS & CONCLUSIONS: Totally 140 related literatures were finally included. In terms of cost measurement, short-term (≤1 year) research accounted for the highest proportion (109 literatures, 77.86%). Cost calculation mostly had no clear research perspective (125 literatures, 89.29%). It did not involve the cost of child productivity. The main shortcomings were unclear time range, incomplete cost calculation (lack of productivity, hidden cost) and so on. In terms of health output measurement, 103 (73.57%) used cost-effectiveness analysis, 23 (16.43%) used cost-benefit analysis, and only 4 (2.86%) related to the use of measurement scales. Main shortcomings included that the difficulty in obtaining outcome indicators, lack of child health output measurement scale and so on. Based on this, it is suggested that related demands should be complied before conducting economics evaluation research, we should clarify the research angle, formulate unified and standardized cost measurement methods, rationally select technical analysis methods and health outflow indicators according to research purposes and disease characteristics, and develop appropriate measurement scales according to the physiological and psychological characteristics of children in different age groups. At the same time, future studies can report on the status of family members when reporting on children's related conditions, and conduct an economic evaluation of therapeutic regimen in the family unit.
期刊: 2019年第30卷第19期
作者: 李文君,王媛,谢雯雯,席晓宇
AUTHORS: LI Wenjun,WANG Yuan,XIE Wenwen,XI Xiaoyu
关键字: 儿童;治疗方案;经济学评价;现状与不足;文献回顾
KEYWORDS: Children; Therapeutic regimen; Economics evaluation; Situation and deficiencies; Literature review
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