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卫生技术评估与经济评估:它适用于传统医学吗?

Health technology assessment and economic evaluation: Is it applicable for the traditional medicine?

作者信息

Chen Yingyao

机构信息

School of Public Health, Fudan University,138, Yi Xue Yuan Road, Shanghai, PR China.

National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, PR China.

出版信息

Integr Med Res. 2022 Mar;11(1):100756. doi: 10.1016/j.imr.2021.100756. Epub 2021 Jul 16.

Abstract

Gaps between limited health resources and expanding health service demands are emerging to be more and more prominent, which extremely generate the cost-effective strategies for scientific policy-making in the context of healthcare. As a systematic approach and solid tool to promote healthcare system more efficient and sustainable, health technology assessment (HTA) could provide multi-dimensional evidences comprising effectiveness, safety, economic implications, ethical, social, cultural and legal issues, in which economic evaluation is an important and unique part for optimizing decision-making. After decades of development, HTA has formulated a set of systematic theories, methods and procedures based on modern medicine. Meanwhile, as an important component of medicine system across the world, traditional medicine (TM) originates from knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different traditional cultures. Yet whether current theory and method system of HTA is applicable for TM is necessary to be explored and investigated. In principle, the general steps and methods of HTA could be basically applicable to TM, except for the PICO structuring, cost measurement, and supportive clinical evidence and information collection in economic evaluation. Therefore, these three challenging problems need to be focused and addressed in future HTA for TM.

摘要

有限的卫生资源与不断扩大的卫生服务需求之间的差距正日益凸显,这迫切需要在医疗保健背景下制定具有成本效益的科学决策策略。作为一种促进医疗保健系统更高效、更可持续的系统方法和坚实工具,卫生技术评估(HTA)可以提供多维度证据,包括有效性、安全性、经济影响、伦理、社会、文化和法律问题,其中经济评估是优化决策的重要且独特的一部分。经过几十年的发展,HTA基于现代医学形成了一套系统的理论、方法和程序。与此同时,作为全球医学体系的重要组成部分,传统医学(TM)源自基于不同传统文化的理论、信仰和经验的知识、技能和实践。然而,HTA当前的理论和方法体系是否适用于传统医学仍有待探索和研究。原则上,HTA的一般步骤和方法基本适用于传统医学,但在经济评估中的PICO构建、成本测量以及支持性临床证据和信息收集方面除外。因此,这三个具有挑战性的问题需要在未来传统医学的HTA中予以关注和解决。

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