:::

詳目顯示

回上一頁
題名:以德菲法建構醫療資源配置:政策利害關係人觀點
書刊名:臺灣公共衛生雜誌
作者:陳珮青李玉春
作者(外文):Chen, Pei-chingLee, Yue-chune
出版日期:2015
卷期:34:2
頁次:頁193-203
主題關鍵詞:德菲法醫療資源配置優先順序Delphi methodHealthcare resource allocationPriority setting
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(3) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:3
  • 共同引用共同引用:5
  • 點閱點閱:51
目標:本研究目的為從政策利害關係人觀點來建構醫療資源配置之原則與標準。方法:藉由德菲法以郵寄問卷方式,針對曾參與健保給付或支付、資源分配規劃或諮詢經驗之政府官員、醫療服務提供者、付費者代表、健保相關學者等共62專家,收集其對於醫療資源配置之看法。結果:兩回合德菲法回收44樣本,回收率70.97%,樣本68.2%為男性,年齡平均值為54.1歲,48.8%具有博士學歷,40.0%具有20年以上工作資歷。對醫療資源配置有以下5點共識:1.資源分配給「加權健康改善程度」最多的一群人,降低族群健康的不平等。2.對資源配置需考量「醫療成本效益」、「保險財務影響」、「有效性」、「公平性」、「人體健康影響」等標準。3.贊成對弱勢族群(除臨終病人及婦女外)給付加重考量。4.醫療資源配置標準重要性依序為「成本效益」、「有效性」、「公平性」及「個人負擔」。5.建立客觀可接受經濟評估閾值。結論:醫療資源配置應訂定原則與標準,及建立客觀可接受成本效益閾值,並考量弱勢族群給付加重。本研究結果可提供衛生福利部在進行醫療資源配置或給付優先順序決策之參考。
Objectives: The aim of this study was to develop the principles of and criteria for healthcare resource allocation in Taiwan from the perspective of policy stakeholders. Methods: Sixty-two experts including government officials, health professionals, healthcare providers, and public/lay representatives were selected to participate via purposive sampling. The Delphi method was used for the collection of data. Two rounds of mailed questionnaires included questions aimed at identifying the criteria used by experts to establish priorities for healthcare insurance benefits. Results: Forty-four respondents completed two rounds of the Delphi exercise for a response rate of 70.97%. Most experts recommended the following: (1) Resources should be allocated according to their effectiveness in maximizing health services and eliminating health inequalities under fixed resources. (2) The criteria for resource allocation, such as cost-effectiveness, insurance financial impact, effectiveness, fairness, and human health outcome should be considered. (3) Disadvantaged groups should be assigned greater weights. (4) The relative importance of the priorities should be cost-effectiveness, effectiveness, fairness, and personal burden. (5) There is a need to establish an objective and acceptable economic assessment threshold. Conclusions: This study provides a valuable resource to guide the allocation of resources and identify the criteria used by governments in the establishment of priorities for the provision of healthcare insurance benefits.
Other
1.黃文彥(20141018)。21萬健保費救1罕病兒。  延伸查詢new window
期刊論文
1.Sabik, L. M.、Lie, R. K.(2008)。Priority setting in health care: Lessons from the experiences of eight countries。Int J Equity Health,7,4。  new window
2.李玉春、黃昱瞳、黃光華、葉玲玲、陳珮青(20140100)。全民健保支付制度改革之回顧與展望。臺灣醫學,18(1),53-66。  延伸查詢new window
3.Donaldson, C.、Mooney, G.(1991)。Needs assessment, priority setting, and contracts for health care: an economic view。BMJ,303,1529-1530。  new window
4.Appleby, J.、Devlin, N.、Parkin, D.(2007)。NICE’s cost effectiveness threshold。BMJ,335,358-359。  new window
5.Laupacis, A.、Feeny, D.、Detsky, A. S.、Tugwell, P. X.(1992)。How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations。CMAJ,146,473-481。  new window
6.Hirth, R. A.、Chernew, M. E.、Miller, E.、Fendrick, A. M.、Weissert, W. G.(2000)。Willingness to pay for a quality-adjusted life year: in search of a standard。Med Decis Making,20,332-342。  new window
7.George, B.、Harris, A.、Mitchell, A.(1991)。Cost-effectiveness analysis and the consistency of decision making: evidence from pharmaceutical reimbursement in Australia。Pharmacoeconomics,19,1103-1109。  new window
8.Golan, O.、Hansen, P.、Kaplan, G.、Tal, O.(2011)。Health technology prioritization: which criteria for prioritizing new technologies and what are their relative weights?。Health Policy,102,126-135。  new window
9.Green, C.(2009)。Investigating public preferences on ‘severity of health’ as a relevant condition for setting healthcare priorities。Soc Sci Med,68,2247-2255。  new window
10.Lim, M. K.、Bae, E. Y.、Choi, S. E.、Lee, E. K.、Lee, T. J.(2012)。Eliciting public preference for health-care resource allocation in South Korea。Value Health,15(1 Suppl),91-94。  new window
11.Guindo, L. A.、Wagner, M.、Baltussen, R.(2012)。From efficacy to equity: literature review of decision criteria for resource allocation and healthcare decisionmaking。Cost Eff Resour Alloc,10,9。  new window
12.Defechereux, T.、Paolucci, F.、Mirelman, A.(2012)。Health care priority setting in Norway a multicriteria decision analysis。BMC Health Serv Res,12,39。  new window
13.Shiroiwa, T.、Sung, Y. K.、Fukuda, T.、Lang, H. C.、Bae, S. C.、Tsutani, K.(2010)。International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?。Health Econ,19(4),422-437。  new window
14.Eichler, H. G.、Kong, S. X.、Gerth, W. C.、Mavros, P.、Jonsson, B.(2004)。Use of cost-effectiveness analysis in healthcare resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge?。Value Health,7,518-528。  new window
15.李卓倫(20071000)。由英國經驗探討臺灣的醫療資源配給。問題與研究,46(4),53-86。new window  延伸查詢new window
16.Hasson, F.、Keeney, S.、McKenna, H.(2000)。Research guidelines for the Delphi survey technique。Journal of Advanced Nursing,32(4),1008-1015。  new window
會議論文
1.李玉春、陳珮青(2012)。醫療資源分配機制~世界經驗與省思。第三波健保改革:醫療資源分配正義機制之建立研討會。台北:財團法人台灣研究基金會:國立台灣大學公共衛生學院。  延伸查詢new window
圖書
1.Drummond, M. F.、Sculpher, M. J.、Torrance, G. W.、O'Brien, B. J.、Stoddart, G. L.(2005)。Methods for the Economic Evaluation of Health Care Programmes。Oxford:Oxford University Press。  new window
2.Aday, L. A.、Bgley, C. E.、Lairson, D. R.、Balkrishnan, R.(2004)。Evaluating the healthcare system。Washington, DC:Health Administration Press。  new window
3.Dunn, William N.(1994)。Public Policy Analysis: An Introduction。Prentice-Hall International Inc.。  new window
圖書論文
1.Garrido, M.、Zentner, A.、Busse, R.(2008)。Health systems, health policy and health technology assessment。Health Technology Assessment and Health Policy-Making in Europe: Current Status, Challenges, and Potential。Copenhagen:World Health Organization, on Behalf of the European Observatory on Health Systems and Policies。  new window
2.賴美淑、楊銘欽、李玉春、溫信財、吳文正(2004)。全民健保醫療資源配置改革策略與規劃。二代健保叢書--全民健保醫療資源配置與合理使用。台北:衛生福利部。  延伸查詢new window
 
 
 
 
第一頁 上一頁 下一頁 最後一頁 top
:::
無相關著作
 
QR Code
QRCODE