购买有价值的医疗卫生服务
|
摘要
政府财政和医疗保险部门是医疗卫生服务的战略购买者。本文重点探讨应购买什么样的医疗卫生服务、什么是有价值的医疗卫生服务以及如何衡量价值。随着高特创新技术的广泛引用,应提高原有QALY的阈值,以适应全生命周期评价的理念。当前面临的挑战是尽早实现全民健康覆盖,实现整合型和多团队合作的服务模式;在服务价格上实现价值与公正并重的定价、获得质量与可承受性的平衡;并控制诱导需求,将健康目标融入各项联动政策。
Government finance and medical insurance departments are strategic purchasers of medical and health services. This article focuses on what kind of medical and health services should be purchased, how to count as valuable services and how to measure the value framework system. With the wide application of higher and special innovative technologies, the original QALY thresholds should be improved to adapt the concept of whole life-cycle assessment. The current challenge is to achieve the universal health coverage as soon as possible, and to achieve integrated medical care and multi-disciplinary team service model. To achieve the balance between value-based pricing and fair pricing as well as quality and affordability in service practice, it is necessary to controlling provider-induced demand and integrating health goals in all policies(HiAP).
Government finance and medical insurance departments are strategic purchasers of medical and health services. This article focuses on what kind of medical and health services should be purchased, how to count as valuable services and how to measure the value framework system. With the wide application of higher and special innovative technologies, the original QALY thresholds should be improved to adapt the concept of whole life-cycle assessment. The current challenge is to achieve the universal health coverage as soon as possible, and to achieve integrated medical care and multi-disciplinary team service model. To achieve the balance between value-based pricing and fair pricing as well as quality and affordability in service practice, it is necessary to controlling provider-induced demand and integrating health goals in all policies(HiAP).
引文
[1]《关于印发基本公共服务领域中央与地方共同财政事权和支出责任划分改革方案的通知》(国办发[2018]6号).
[2]《医疗卫生领域中央与地方财政事权和支出责任划分改革方案的通知》(国办发[2018]67号).
[3]胡善联.医疗卫生领域财政事权和支出责任划分研究---基于卫生经济学理论[J].卫生经济研究,2018(10):3-5.
[4]Neumann PJ,Willke RJ,Garrison LP.A Health Economics Approach to US Value Assessment Frameworks-Introduction:An ISPOR Special Task Force Report[1][J].Value in Health,2018,21(2):119-123.
[5]Lakdawalla DN,et al.Defining Elements of Value in Health Care-A Health Economics Approach:An ISPOR Special Task Force Report[3][J].Value in Health,2018,21(2):131-139.
[6]Moriates Christopher,et al.吴明主审,杨莉主译.以价值为导向的医疗服务[M].北京:北京大学医学出版社,2018.
[7]世界银行集团,世界卫生组织,财政部,国家卫生和计划生育委员会,人力资源和社会保障部.健康中国---深化中国医药卫生体制改革,建设基于价值的优质服务体系:政策总论[M].2016.
[8]Nitzan A,et al.Multi-disciplinary patient-centered model for the expedited provision of costly therapies in community setting the case of new medication for hepatitis C[J].Israel J Health Policy,2017(6):46.
[9]WHO:Fair Pricing Forum.2017 Meeting Report.Amsterdam,The Netherlands.11,May,2017.
[10]World Bank:Results-based Financing(RBF)for Health.E-course.2015.
[2]《医疗卫生领域中央与地方财政事权和支出责任划分改革方案的通知》(国办发[2018]67号).
[3]胡善联.医疗卫生领域财政事权和支出责任划分研究---基于卫生经济学理论[J].卫生经济研究,2018(10):3-5.
[4]Neumann PJ,Willke RJ,Garrison LP.A Health Economics Approach to US Value Assessment Frameworks-Introduction:An ISPOR Special Task Force Report[1][J].Value in Health,2018,21(2):119-123.
[5]Lakdawalla DN,et al.Defining Elements of Value in Health Care-A Health Economics Approach:An ISPOR Special Task Force Report[3][J].Value in Health,2018,21(2):131-139.
[6]Moriates Christopher,et al.吴明主审,杨莉主译.以价值为导向的医疗服务[M].北京:北京大学医学出版社,2018.
[7]世界银行集团,世界卫生组织,财政部,国家卫生和计划生育委员会,人力资源和社会保障部.健康中国---深化中国医药卫生体制改革,建设基于价值的优质服务体系:政策总论[M].2016.
[8]Nitzan A,et al.Multi-disciplinary patient-centered model for the expedited provision of costly therapies in community setting the case of new medication for hepatitis C[J].Israel J Health Policy,2017(6):46.
[9]WHO:Fair Pricing Forum.2017 Meeting Report.Amsterdam,The Netherlands.11,May,2017.
[10]World Bank:Results-based Financing(RBF)for Health.E-course.2015.