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Priorización de intervenciones sanitarias. Revisión de criterios, enfoques y rol de las agencias de evaluación

Published on Jul 1, 2017in Gaceta Sanitaria 1.66
· DOI :10.1016/j.gaceta.2016.09.015
Leonor Varela-Lema5
Estimated H-index: 5
,
Gerardo Atienza-Merino1
Estimated H-index: 1
,
Marisa López-García2
Estimated H-index: 2
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Abstract
Resumen Objetivo El presente trabajo surge con el proposito de desarrollar una metodologia explicita para la seleccion de prioridades sanitarias que apoye la toma de decisiones sobre las tecnologias a evaluar de cara a su inclusion en la cartera de servicios del Sistema Nacional de Salud. El objetivo principal es identificar y analizar los criterios, procesos y marcos conceptuales empleados para la priorizacion de intervenciones sanitarias en el ambito nacional e internacional. Metodo Se ha llevado a cabo una revision exhaustiva de la literatura. Para ello, se ha buscado en las principales bases de datos biomedicas y se han revisado las paginas web de las principales agencias de evaluacion, entre otras fuentes. Resultados En terminos generales, se encontro que no existen criterios universales ni procedimientos estandar para la asignacion de prioridades, aunque se han identificado algunos acuerdos y tendencias comunes respecto a aspectos fundamentales (criterios, modelos y estrategias, actores clave, etc.). Globalmente se identificaron ocho dominios criticos: 1) necesidad de la intervencion; 2) resultados en salud; 3) tipo de beneficio de la intervencion; 4) consecuencias economicas; 5) conocimiento existente sobre la intervencion/calidad e incertidumbre de la evidencia; 6) implementacion y complejidad de la intervencion/factibilidad; 7) prioridad, justicia y etica; y 8) contexto global. Conclusiones La revision proporciona un analisis detallado de los aspectos relevantes y ofrece recomendaciones clave para el desarrollo de un marco de priorizacion nacional. Se plantea que esta informacion podria ser util para diferentes organizaciones publicas que pretendan establecer prioridades sanitarias.
  • References (22)
  • Citations (1)
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References22
Newest
Nataly Tanios1
Estimated H-index: 1
(UdeM: Université de Montréal),
Monika Wagner12
Estimated H-index: 12
(Analytica)
+ 5 AuthorsMireille Goetghebeur16
Estimated H-index: 16
(UdeM: Université de Montréal)
Objectives: The aim of this study was to gather qualitative and quantitative data on criteria considered by healthcare decision makers. Methods: Using snowball sampling and an online questionnaire with forty-three criteria organized into ten clusters, decision makers were invited by an international task force to report which criteria they consider when making decisions on healthcare interventions in their context. Respondents reported whether each criterion is "currently considered," "should be...
49 Citations Source Cite
Danguole Jankauskiene2
Estimated H-index: 2
(Mykolas Romeris University),
Gintare Petronyte1
Estimated H-index: 1
(Mykolas Romeris University)
4 Citations Source Cite
Published on Sep 1, 2013in Journal of Public Health 1.65
K. Marsh1
Estimated H-index: 1
,
P. Dolan1
Estimated H-index: 1
(LSE: London School of Economics and Political Science)
+ 1 AuthorsM. Lugon1
Estimated H-index: 1
Background The evidence on public health interventions has traditionally focussed on a limited number of costs and benefits, adopted inconsistent methods and is not always relevant to the UK context. This paper develops a multi-criteria decision analysis (MCDA) approach to overcome these challenges. Methods A document review and stakeholder consultation was used to identify interventions and the criteria against which they should be assessed. The interventions were measured against these criteri...
33 Citations Source Cite
Published on Dec 1, 2012in BMC Health Services Research 1.93
Noor Tromp4
Estimated H-index: 4
(Radboud University Nijmegen),
Rob Baltussen39
Estimated H-index: 39
(Radboud University Nijmegen)
Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frameworks. This ...
44 Citations Source Cite
Mira Johri18
Estimated H-index: 18
(UdeM: Université de Montréal),
Ole Frithjof Norheim42
Estimated H-index: 42
(University of Bergen)
Objectives: The aim of this study was to promote approaches to health technology assessment (HTA) that are both evidence-based and values-based. We conducted a systematic review of published studies describing formal methods to consider equity in the context of cost-effectiveness analysis (CEA). Methods: Candidate studies were identified through an unrestricted search of the Pub Med and EMBASE databases. The search closed on January 20, 2011. We identified additional studies by consulting expert...
46 Citations Source Cite
Published on Mar 1, 2012in Medical Decision Making 2.79
Mireille Goetghebeur16
Estimated H-index: 16
,
Monika Wagner12
Estimated H-index: 12
+ 3 AuthorsDonna Rindress9
Estimated H-index: 9
Background. Health care decision making is complex and requires efficient and explicit processes to ensure transparency and consistency of factors considered. Objectives. To pilot an adaptable decision-making framework incorporating multicriteria decision analysis (MCDA) in health technology assessment (HTA) with a pan-Canadian group of policy and clinical decision makers and researchers appraising 10 medicines covering 6 therapeutic areas. Methods. An appraisal group was convened and participan...
82 Citations Source Cite
Published on Jan 1, 2012in Cost Effectiveness and Resource Allocation 1.68
Lalla Aïda Guindo1
Estimated H-index: 1
,
Monika Wagner12
Estimated H-index: 12
+ 4 AuthorsMireille Goetghebeur16
Estimated H-index: 16
(UdeM: Université de Montréal)
Objectives: Resource allocation is a challenging issue faced by health policy decisionmakers requiring careful consideration of many factors. Objectives of this study were to identify decision criteria and their frequency reported in the literature on healthcare decisionmaking. Method: An extensive literature search was performed in Medline and EMBASE to identify articles reporting healthcare decision criteria. Studies conducted with decisionmakers (e.g., focus groups, surveys, interviews), conc...
100 Citations Source Cite
Published on Oct 1, 2011in Health Policy 2.08
Ofra Golan3
Estimated H-index: 3
(Sheba Medical Center),
Paul Hansen23
Estimated H-index: 23
(University of Otago)
+ 1 AuthorsOrna Tal1
Estimated H-index: 1
(Sheba Medical Center)
Objectives: To review the criteria and OotherO considerations used internationally for prioritising new health technologies, and to demonstrate a conjoint-analysis methodology for deriving relative weights for the criteria. Methods: We searched the literature for criteria and other considerations used internationally for prioritising new technologies. For a set of criteria related to the ObenefitsO from technologies, we used a conjoint-analysis survey with a convenience sample of 74 participants...
61 Citations Source Cite
Published on Jan 1, 2011in Cost Effectiveness and Resource Allocation 1.68
Sitaporn Youngkong5
Estimated H-index: 5
(Radboud University Nijmegen Medical Centre),
Noor Tromp6
Estimated H-index: 6
(Radboud University Nijmegen Medical Centre),
Dereck Chitama1
Estimated H-index: 1
(Radboud University Nijmegen Medical Centre)
Correction After the publication of this article [1], we became aware that two last sentences in the paragraph relied on original ideas following personal communication with a researcher, and should not have been presented here. Consequently, the reference number 9 which was cited for the removed issue should be taken from the article. The correct paragraph is provided below: The explicit weighing of criteria analyzed from DCE may improve the consistency of priority setting across contexts and o...
9 Citations Source Cite
Published on Jan 1, 2011
N. Devlin1
Estimated H-index: 1
,
J. Sussex1
Estimated H-index: 1
What a health care system should pay for depends, of course, on the health gain that results. Health technology assessment (HTA) and cost-effectiveness analysis have become the core for many such decisions, by NICE in the UK and by similar bodies elsewhere. Other factors, however, also are taken into account by the governments and insurers who fund health care. These typically include - the impact of decisions on social equity[]; the quality of the patient experience; ramifications for the wider...
68 Citations