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优先考虑疾病早期干预。

Prioritizing Early Disease Intervention.

作者信息

Caicedo H Hugo, Darrow Jonathan J, Caicedo Julio C, Pentland Alex

机构信息

Connection Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.

Corporate Sustainability and Innovation, Harvard University, Cambridge, MA, USA.

出版信息

Ther Innov Regul Sci. 2023 Nov;57(6):1148-1152. doi: 10.1007/s43441-023-00569-3. Epub 2023 Sep 5.

Abstract

Scholars and practitioners have described how investing in health care earlier rather than later can be beneficial, from how "biomarkers" offer promise for early disease detection to healthcare system "incentives" that can promote early preventive medicine. Work by health economists has also made clear that the "health capital" of an individual depreciates over time in the absence of investments in health. Yet, our current policy makers and healthcare system continue prioritizing care of late-stage complex symptomatic illness, often when cure is impossible and disease reversal is improbable, thus exacerbating public health burdens. Critically missing are predicates to address this challenge include the following: first, identifying and validating the specific set of presymptomatic biomarkers that will inform the most appropriate intervention timing for those medical conditions amenable to early intervention; second, shifting fundamental health economic incentives to influence the appropriate disease prevention market; and third, formulating and executing a viable economic framework of reimbursement. We examine these predicates and propose actionable policy recommendations that may help align stakeholder interests to improve public health.

摘要

学者和从业者已经描述了尽早而非推迟投资医疗保健如何有益,从“生物标志物”为早期疾病检测带来希望到医疗保健系统的“激励措施”可以促进早期预防医学。卫生经济学家的研究也表明,在缺乏健康投资的情况下,个人的“健康资本”会随着时间的推移而贬值。然而,我们当前的政策制定者和医疗保健系统继续优先考虑晚期复杂症状疾病的护理,通常是在无法治愈且疾病逆转可能性不大的时候,从而加剧了公共卫生负担。至关重要的是,应对这一挑战的前提条件包括以下几点:第一,识别和验证特定的一组症状前生物标志物,这些生物标志物将为那些适合早期干预的医疗状况提供最合适的干预时机;第二,转变基本的健康经济激励措施,以影响适当的疾病预防市场;第三,制定和执行可行的报销经济框架。我们研究了这些前提条件,并提出了可行的政策建议,这些建议可能有助于使利益相关者的利益保持一致,以改善公共卫生。

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