Health-care decision-making processes in Latin America: Problems and prospects for the use of economic evaluation

被引:65
作者
Iglesias, CP [1 ]
Drummond, MF
Rovira, J
机构
[1] Univ York, York YO10 5DD, N Yorkshire, England
[2] Univ Barcelona, Barcelona, Spain
关键词
economic evaluation; Latin America; decision-making; survey; review;
D O I
10.1017/S0266462305050014
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives: The use of economic evaluation studies (EE) in the decision-making process within the health-care system of nine Latin American (LA) and three European countries was investigated. The aim was to identify the opportunities, obstacles, and changes needed to facilitate the introduction of EE as a formal tool in health-care decision-making processes in LA. Methods: A comparative study was conducted based on existing literature and information provided through a questionnaire applied to decision makers in Argentina, Brazil, Colombia, Cuba, Mexico, Nicaragua, Peru, Portugal Spain, United Kingdom, Uruguay, and Venezuela. Systematic electronic searches of HEED, NHS EED, and LILACS were conducted to identify published economic evaluation studies in LA from 1982 onward. Results: There is relatively little evidence of the conduct and use of EE within the health care systems in LA. Electronic searches retrieved 554 records; however, only 93 were EE. In the nine LA participating countries, broad allocation of health-care resources is primarily based on political criteria, historical records, geographical areas, and specific grounds of patients and diseases. Public-health provision and inclusion of services in health-insurance package are responsibilities of the Ministry of Health. Decisions regarding the purchase of medicines are primarily made through public tenders, and mainly based on differences in clinical efficacy and the price of health technologies of interest. Conclusions: To expedite the process of incorporating EE as a formal tool to inform decision-making processes within the health-care systems in LA countries, two main conditions need to be fulfilled. First, adequate resources and skills need to be available to conduct EE of good quality. Second, decision-making procedures need to be modified to accommodate "evidence-based" approaches such as EE.
引用
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页码:1 / 14
页数:14
相关论文
共 18 条
[1]  
CATANO C, 1992, EVALUACION COSTO EFI, P49
[2]   Assessing the appropriateness of combining economic data from multinational clinical trials [J].
Cook, JR ;
Drummond, M ;
Glick, H ;
Heyse, JF .
STATISTICS IN MEDICINE, 2003, 22 (12) :1955-1976
[3]  
*CRD, 2003, NHS EC EV DAT NHS EE
[4]  
Drummond M, 1999, Value Health, V2, P323, DOI 10.1046/j.1524-4733.1999.25003.x
[5]  
DRUMMOND M, 2001, EC EVALUATION HLTH C, pCH11
[6]  
GALVEZ AM, HPP REPORT SERIES
[7]  
Kielhorn A, 2000, HLTH EC HDB
[8]  
NUNES A, 1997, IMPACTO EC AIDS HIV
[9]  
*OHEIFPMA, 2003, HLTH EC EV DAT HEED
[10]  
ORTIZ JS, 2000, ESTUDIO COSTOS EVALU