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

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2009 in BMC Health Services Research [IF: 1.84]
Shannon L Sibbald1
Estimated H-index: 1
(University of Toronto),
Peter Singer76
Estimated H-index: 76
,
Ross Upshur44
Estimated H-index: 44
(University of Toronto)
... more
Background The sustainability of healthcare systems worldwide is threatened by a growing demand for services and expensive innovative technologies. Decision makers struggle in this environment to set priorities appropriately, particularly because they lack consensus about which values should guide their decisions. One way to approach this problem is to determine what all relevant stakeholders understand successful priority setting to mean. The goal of this research was to develop a conceptual fr...
123 Citations Download PDF Cite
Mira Johri18
Estimated H-index: 18
(Université de Montréal),
Ole Frithjof Norheim40
Estimated H-index: 40
(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...
42 Citations Download PDF Cite
Per Carlsson29
Estimated H-index: 29
(Linköping University)
This article describes the development of health technology assessment (HTA) in Sweden, its influence on decision making, and its link with priority setting. Sweden has a well established governmental HTA body, the Swedish Council on Technology Assessment in Health Care (SBU), and an increasing number of regional/local HTA organizations. HTA has had an impact on clinical practice and is used to some extent in policy decisions. Several initiatives have now been taken to develop processes for open...
53 Citations Source Cite
Danguole Jankauskiene2
Estimated H-index: 2
(Mykolas Romeris University),
Gintare Petronyte1
Estimated H-index: 1
(Mykolas Romeris University)
3 Citations Source Cite
Berit Mørland6
Estimated H-index: 6
,
Ånen Ringard2
Estimated H-index: 2
,
John-Arne Røttingen21
Estimated H-index: 21
Objectives: We describe, in general, the principles used in priority setting and, in particular, policy processes and decision making in Norway. Methods: A newly established council for setting priorities in health care is presented to illustrate how health technology assessments (HTAs) can support national advisors in complex priority-setting processes. Results and Conclusions: Setting priorities in health care is a complex task. Careful thinking is, therefore, required in determining the compo...
13 Citations Source Cite
2010 in BMC Health Services Research [IF: 1.84]
Annette Plüddemann16
Estimated H-index: 16
(University of Oxford),
Carl Heneghan45
Estimated H-index: 45
(University of Oxford),
Matthew Thompson40
Estimated H-index: 40
(University of Oxford)
... more
Background Currently there is no framework for those involved in the identification, evaluation and prioritisation of new diagnostic technologies. Therefore we aimed to develop prioritisation criteria for the assessment of new diagnostic technologies, by gaining international consensus on not only which criteria should be used, but also their relative importance.
12 Citations Source Cite
1998 in BMJ [IF: 23.56]
S⊘ren Holm1
Estimated H-index: 1
,
James E. Sabin23
Estimated H-index: 23
,
David Chinitz15
Estimated H-index: 15
... more
# The second phase of priority setting {#article-title-2} Editorial by Klein This article was presented at the second international conference on priorities in health care in London on 8-10 October 1998 This week sees the second international conference on priorities in health care in London. To mark the occasion we are publishing three of the papers that will be presented at the conference. Each illustrates, in a different way, how thinking about priority setting in health care has developed ov...
94 Citations Download PDF Cite
2012 in BMC Health Services Research [IF: 1.84]
Noor Tromp3
Estimated H-index: 3
(Radboud University Nijmegen),
Rob Baltussen31
Estimated H-index: 31
(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 ...
42 Citations Download PDF Cite
László Gulácsi23
Estimated H-index: 23
,
I Boncz16
Estimated H-index: 16
,
Michael Drummond70
Estimated H-index: 70
(University of York)
Objectives: This study outlines the needs and current development of the "fourth hurdle" (i.e., requirement of effectiveness and cost-effectiveness data for drug coverage policy decisions) in Hungary, describes the legal background and seeks to address some of the most important questions in this field. Methods: The study draws on international experiences and discusses five issues that a given jurisdiction needs to consider before introducing the "fourth hurdle" for pharmaceuticals. Results: Th...
27 Citations Download PDF Cite
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