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Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye'de Durum

Yıl 2007, Cilt: 10 Sayı: 2, 109 - 137, 01.04.2007

Hacer Özgen Mehtap Tatar

Öz

Artan sağlık ihtiyaçları ve gelişen teknoloji, karar vericileri kıt olan kaynaklarla daha fazla sağlık hizmeti sunma veya finanse etme sorunu ile karşı karşıya bırakmıştır. Dolayısıyla bu sorun kaynakların hangi nüfus grupları, hangi hastalıklar ve hangi müdahaleler için tahsis edileceği konularında rasyonel kararlar verilmesinin önemini artırmıştır. Maliyet-etkililik analizi kaynakların verimli tahsisi ile ilgili karar sürecinde dikkate alınması gereken önemli bir kriterdir. Bu makale, bir verimlilik değerlendirme tekniği olarak maliyet-etkililik analizi, sağlık sektöründe kullanımı ve Türkiye’de bu konu ile ilgili gelişmeleri ele almaktadır. İlk olarak konuya ilişkin kapsamlı bir teorik çerçeve ortaya konmuş daha sonra Türkiye’deki gelişmeler incelenmiştir

Anahtar Kelimeler

-

Kaynakça

  • Aday L.A. et al. (1993) Evaluating the Medical Care System: Effectiveness, Efficiency, and Equity. Health Administration Press, University of Michigan (Ann Arbor, MI). 2.
  • Ades A.E., Claxton K. and Sculpher M. (2006) Evidence Synthesis, Parameter Correlation and Probabilistic Sensitivity Analysis. Health Economics 15(4): 373-381. 3.
  • Ades A.E. and Cliffe S. (2002) Markov chain Monte Carlo estimation of a multiparameter decision model: consistency of evidence and the accurate assessment of uncertainty. Medical Decision Making 22: 359– 371. 4.
  • Anderson J.P. et al. (1986) Policy space areas and properties of benefit- cost/utility analysis. JAMA 255: 794-795. 5.
  • Arrow K.J. (1963) Uncertainty and the Welfare Economics of Medical Care. American Economic Review 53(3): 941–973. 6.
  • Black W.C. (1990) The CE Plane: A Graphic Representation of Cost- Effectiveness. Medical Decision Making 10: 212-214.
  • Boadway R. and Bruce N. (1984) Welfare Economics. Oxford: Basil Blackwell.
  • Briggs A. and Fenn P. (1998) Confidence Intervals or Surfaces? Uncertainty on the Cost-Effectiveness Plane. Health Economics 7: 723- Brook R. and Lohr K. (1985) Efficacy, Effectiveness, Variations, and Quality: Boundary-Crossing Research. Medical care 23(suppl.): 710- 722.
  • Claxton K., Sculpher M., McCabe C. et al. (2005) Probabilistic Sensitivity Analysis for NICE Technology Assessment: Not An Optional Extra. Health Economics 14: 339–347.
  • Coast J. (2004) Is economic evaluation in touch with society's health values? British Medical Journal 329: 1233-1236.
  • Cookson R. et al. (2001) Worng SIGN, NICE Mess: Is National Guidance Distorting Allocation of Resources? British Medical Journal 323: 743-745.
  • Diel R., Nienhaus A. and Loddenkempe R. (2007) Cost-effectiveness of Interferon-Release Assay Screening for Latent Tuberculosis Infection Treatment in Germany. CHEST 131:1424–1434.
  • Doubilet P., Begg C.B., Weinstein M.C., Braun P. and McNeil B.J. (1985) Probabilistic sensitivity analysis using Monte Carlo simulation. A practical approach. Medical Decision Making5(2): 157-177
  • Drummond M.F. et al. (2006) Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press Inc., New York.
  • Drummond M.F. (2003) The Use of Economic Information by Reimbursement Authorities. Rheumatology 42(Supply. 3): iii60-iii63.
  • Drummond M.F., Aguiar-Ibáñez, R. and Nixon, J. (2006) Economic Evaluation. Singapore Medical Journal 47(6): 456-462.
  • Ebri A., Kuper H. and Wedner S. (2007) Cost-Effectiveness of Cycloplegic Agents: Results of a Randomized Controlled Trial in Nigerian Children. Investigative Ophthalmology & Visual Science 48(3): 1025-1031.
  • Elliott R. and Payne K. (2005) Essentials of Economic Evaluation in Health Care. Pharmaceutical Press, London.
  • Folland S. et al. (1997) The Economics of Health and Health Care. New Jersey: Prentice Hall.
  • Gafni A. and Birch S. (2006) Incremental Cost-effectiveness ratios (ICERs): The Silence of the Lambda. Social Science and Medicine 62: 2091-2100.
  • Gage H. et al. (2006) Evaluating rehabilitation using cost-consequences analysis: an example in Parkinson's disease. Clinical Rehabilitation 20: 232-238.
  • Groot KB. et al. (2007). Limitations of acceptability curves for presenting uncertainty in cost-effectiveness analysis. Medical Decision Making 27: 101-111.
  • Hutubessy R. et al. (2003) Generalized Cost-Effectiveness Analysis for National-level Priority-setting in the Health Sector. Cost Effectiveness and Resource Allocation 1: 8-20.
  • Jacobs R. et al. (2006) Measuring Efficiency in Health Care. Cambridge University Press, UK.
  • James M. et al. (2005) A Cost Consequences Analysis of Local Corticosteroid Injection and Physiotherapy for the Treatment of New Episodes of Unilateral Shoulder Pain in Primary Care. Rheumatology 44(11):1447-1451.
  • Lipscomb J., Weinstein M.C. and Torrance G.W. (1996) “Time Preference”. In Gold M.R., Siegel J.E., Russell L.B. and Weinstein M.C. (eds.) Cost Effectiveness in Health and Medicine, pp:214-246. Oxford University Press.
  • Liu et al. (2005) Health Care and Pharmaceutical Spending in Turkey. SUVAK, Ankara. (www.suvak.org.tr)
  • Lord J. and Asante M.A. (1999) Estimating Uncertainty Ranges for Costs by the Bootstrap Procedure Combined with Probabilistic Sensitivity Analysis. Health Economics 8: 323–333.
  • Mandelblatt J.S. et al. (1996) “Assessing the Effectiveness of Health Interventions”. In Gold M.R., Siegel J.E., Russell L.B. and Weinstein M.C. (eds.) Cost Effectiveness in Health and Medicine, pp:135-175. Oxford University Press.
  • Manning W.G., Fryback D.G. and Weinstein M.C. (1996) “Time Preference”. In Gold M.R., Siegel J.E., Russell L.B. and Weinstein M.C. (eds.) Cost Effectiveness in Health and Medicine, pp:214-246. Oxford University Press.
  • Meltzer M.I. (2001) Introduction to Health Economics for Physicians. Lancet 358: 993–998.
  • Multicentre Aneurysm Screening Study (MASS) (2002) Cost effectiveness analysis of screening for abdominal aortic aneurysms based on four year results from randomised controlled trial. British Medical Journal 325:1135.
  • Murray C.J.L. et al. (2000) Development of WHO Guidelines on Generalized Cost-effectiveness Analysis. Health Economics 9: 235-251. Mushkin S.J. (1958) Toward A Definition of Health Economics. Public Health Reports 73(9): 785- 793.
  • Mushkin S.J. (1962) Health as an Investment. Journal of Political Economy 70(5): 129-157.
  • Plant P.K., Owen J.L., Parrott S. and Elliott M.W. (2003) Cost Effectiveness of Ward Based Non-Invasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Economic Analysis of Randomised Controlled Trial. British Medical Journal 326: Robertson J. et al. (2003) Use of Pharmacoeconomics in Prescribing Research. Part 1: Costs – Moving Beyond the Acquisition Price for Drugs. Journal of Clinical Pharmacy and Therapeutics 28: 73–79.
  • Samuelson P.A. and Nordhaus W.D. (1995) Micro Economics. McGraw- Hill, Inc.
  • Sendi P.P. and Briggs A.H. (2001) Affordability and Cost-Effectiveness: Decision-making on the Cost-Effectiveness Plane. Health Economics 10: 675-680.
  • Sendi P., Gafni A. and Birch S. (2002) Opportunity Costs and Uncertainty in the Economic Evaluation of Health Care Interventions. Health Economics 11: 23-31.
  • Stinnett A.A. and Mullahy J. (1998) Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis. Medical Decision Making 18(2 Suppl): S68-80.
  • Suraratdecha C., Ramana C.B.S.V., Kaipilyawar S., Krishnamurthy J.V.G., Sivalenka S., Ambatipudi N., Gandhi S., Umashankar K. & Cheyne J. (2008) Cost and effectiveness analysis of immunization service delivery support in Andhra Pradesh, India. Bulletin of the World Health
  • (http://www.ncbi.nlm.nih.gov) (Erişim Tarihi 13 Haziran 2008) 86. Elektronik
  • Sürüm Tan-Torres Edejer T. et al. (2003) Making Choices in Health Care: WHO Guide to Cost-Effectiveness Analysis. World Health Organization, Geneva.
  • Tatar M. (2007) Pharmaprofile. Turkey. Pharmaceutical Pricing and Reimbursement Information (PPRI) (www.ppri.oebig.at).
  • Van Hout B. et al. (1994) Costs, Effects and C/E Ratios Alongside A Clinical Trial. Health Economics 3: 309-319.
  • Wake N. et al. (2000) Cost-Effectiveness of Intensive Insulin Therapy for Type 2 Diabetes: A 10-Year Follow-up of the Kumamoto Study. Diabetes Research and Clinical Practice 48(3): 201-210.
  • Walley T. (2004) Pharmacoeconomics and Economic Evaluation of Drug Therapies. In du Souich P. et al. (eds.) The IUPHAR Compendium of Basic Principles for Pharmacological Research in Humans, pp:67-75. Department of Pharmacology College of Medicine, University of California, USA.
  • WHO (2007) An Overview of the Rationale, Activities and Goals of WHO-CHOICE, http://www.who.int/choice/description/importance/en, 27.08.2007.

Yıl 2007, Cilt: 10 Sayı: 2, 109 - 137, 01.04.2007

Hacer Özgen Mehtap Tatar

Öz

Kaynakça

  • Aday L.A. et al. (1993) Evaluating the Medical Care System: Effectiveness, Efficiency, and Equity. Health Administration Press, University of Michigan (Ann Arbor, MI). 2.
  • Ades A.E., Claxton K. and Sculpher M. (2006) Evidence Synthesis, Parameter Correlation and Probabilistic Sensitivity Analysis. Health Economics 15(4): 373-381. 3.
  • Ades A.E. and Cliffe S. (2002) Markov chain Monte Carlo estimation of a multiparameter decision model: consistency of evidence and the accurate assessment of uncertainty. Medical Decision Making 22: 359– 371. 4.
  • Anderson J.P. et al. (1986) Policy space areas and properties of benefit- cost/utility analysis. JAMA 255: 794-795. 5.
  • Arrow K.J. (1963) Uncertainty and the Welfare Economics of Medical Care. American Economic Review 53(3): 941–973. 6.
  • Black W.C. (1990) The CE Plane: A Graphic Representation of Cost- Effectiveness. Medical Decision Making 10: 212-214.
  • Boadway R. and Bruce N. (1984) Welfare Economics. Oxford: Basil Blackwell.
  • Briggs A. and Fenn P. (1998) Confidence Intervals or Surfaces? Uncertainty on the Cost-Effectiveness Plane. Health Economics 7: 723- Brook R. and Lohr K. (1985) Efficacy, Effectiveness, Variations, and Quality: Boundary-Crossing Research. Medical care 23(suppl.): 710- 722.
  • Claxton K., Sculpher M., McCabe C. et al. (2005) Probabilistic Sensitivity Analysis for NICE Technology Assessment: Not An Optional Extra. Health Economics 14: 339–347.
  • Coast J. (2004) Is economic evaluation in touch with society's health values? British Medical Journal 329: 1233-1236.
  • Cookson R. et al. (2001) Worng SIGN, NICE Mess: Is National Guidance Distorting Allocation of Resources? British Medical Journal 323: 743-745.
  • Diel R., Nienhaus A. and Loddenkempe R. (2007) Cost-effectiveness of Interferon-Release Assay Screening for Latent Tuberculosis Infection Treatment in Germany. CHEST 131:1424–1434.
  • Doubilet P., Begg C.B., Weinstein M.C., Braun P. and McNeil B.J. (1985) Probabilistic sensitivity analysis using Monte Carlo simulation. A practical approach. Medical Decision Making5(2): 157-177
  • Drummond M.F. et al. (2006) Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press Inc., New York.
  • Drummond M.F. (2003) The Use of Economic Information by Reimbursement Authorities. Rheumatology 42(Supply. 3): iii60-iii63.
  • Drummond M.F., Aguiar-Ibáñez, R. and Nixon, J. (2006) Economic Evaluation. Singapore Medical Journal 47(6): 456-462.
  • Ebri A., Kuper H. and Wedner S. (2007) Cost-Effectiveness of Cycloplegic Agents: Results of a Randomized Controlled Trial in Nigerian Children. Investigative Ophthalmology & Visual Science 48(3): 1025-1031.
  • Elliott R. and Payne K. (2005) Essentials of Economic Evaluation in Health Care. Pharmaceutical Press, London.
  • Folland S. et al. (1997) The Economics of Health and Health Care. New Jersey: Prentice Hall.
  • Gafni A. and Birch S. (2006) Incremental Cost-effectiveness ratios (ICERs): The Silence of the Lambda. Social Science and Medicine 62: 2091-2100.
  • Gage H. et al. (2006) Evaluating rehabilitation using cost-consequences analysis: an example in Parkinson's disease. Clinical Rehabilitation 20: 232-238.
  • Groot KB. et al. (2007). Limitations of acceptability curves for presenting uncertainty in cost-effectiveness analysis. Medical Decision Making 27: 101-111.
  • Hutubessy R. et al. (2003) Generalized Cost-Effectiveness Analysis for National-level Priority-setting in the Health Sector. Cost Effectiveness and Resource Allocation 1: 8-20.
  • Jacobs R. et al. (2006) Measuring Efficiency in Health Care. Cambridge University Press, UK.
  • James M. et al. (2005) A Cost Consequences Analysis of Local Corticosteroid Injection and Physiotherapy for the Treatment of New Episodes of Unilateral Shoulder Pain in Primary Care. Rheumatology 44(11):1447-1451.
  • Lipscomb J., Weinstein M.C. and Torrance G.W. (1996) “Time Preference”. In Gold M.R., Siegel J.E., Russell L.B. and Weinstein M.C. (eds.) Cost Effectiveness in Health and Medicine, pp:214-246. Oxford University Press.
  • Liu et al. (2005) Health Care and Pharmaceutical Spending in Turkey. SUVAK, Ankara. (www.suvak.org.tr)
  • Lord J. and Asante M.A. (1999) Estimating Uncertainty Ranges for Costs by the Bootstrap Procedure Combined with Probabilistic Sensitivity Analysis. Health Economics 8: 323–333.
  • Mandelblatt J.S. et al. (1996) “Assessing the Effectiveness of Health Interventions”. In Gold M.R., Siegel J.E., Russell L.B. and Weinstein M.C. (eds.) Cost Effectiveness in Health and Medicine, pp:135-175. Oxford University Press.
  • Manning W.G., Fryback D.G. and Weinstein M.C. (1996) “Time Preference”. In Gold M.R., Siegel J.E., Russell L.B. and Weinstein M.C. (eds.) Cost Effectiveness in Health and Medicine, pp:214-246. Oxford University Press.
  • Meltzer M.I. (2001) Introduction to Health Economics for Physicians. Lancet 358: 993–998.
  • Multicentre Aneurysm Screening Study (MASS) (2002) Cost effectiveness analysis of screening for abdominal aortic aneurysms based on four year results from randomised controlled trial. British Medical Journal 325:1135.
  • Murray C.J.L. et al. (2000) Development of WHO Guidelines on Generalized Cost-effectiveness Analysis. Health Economics 9: 235-251. Mushkin S.J. (1958) Toward A Definition of Health Economics. Public Health Reports 73(9): 785- 793.
  • Mushkin S.J. (1962) Health as an Investment. Journal of Political Economy 70(5): 129-157.
  • Plant P.K., Owen J.L., Parrott S. and Elliott M.W. (2003) Cost Effectiveness of Ward Based Non-Invasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Economic Analysis of Randomised Controlled Trial. British Medical Journal 326: Robertson J. et al. (2003) Use of Pharmacoeconomics in Prescribing Research. Part 1: Costs – Moving Beyond the Acquisition Price for Drugs. Journal of Clinical Pharmacy and Therapeutics 28: 73–79.
  • Samuelson P.A. and Nordhaus W.D. (1995) Micro Economics. McGraw- Hill, Inc.
  • Sendi P.P. and Briggs A.H. (2001) Affordability and Cost-Effectiveness: Decision-making on the Cost-Effectiveness Plane. Health Economics 10: 675-680.
  • Sendi P., Gafni A. and Birch S. (2002) Opportunity Costs and Uncertainty in the Economic Evaluation of Health Care Interventions. Health Economics 11: 23-31.
  • Stinnett A.A. and Mullahy J. (1998) Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis. Medical Decision Making 18(2 Suppl): S68-80.
  • Suraratdecha C., Ramana C.B.S.V., Kaipilyawar S., Krishnamurthy J.V.G., Sivalenka S., Ambatipudi N., Gandhi S., Umashankar K. & Cheyne J. (2008) Cost and effectiveness analysis of immunization service delivery support in Andhra Pradesh, India. Bulletin of the World Health
  • (http://www.ncbi.nlm.nih.gov) (Erişim Tarihi 13 Haziran 2008) 86. Elektronik
  • Sürüm Tan-Torres Edejer T. et al. (2003) Making Choices in Health Care: WHO Guide to Cost-Effectiveness Analysis. World Health Organization, Geneva.
  • Tatar M. (2007) Pharmaprofile. Turkey. Pharmaceutical Pricing and Reimbursement Information (PPRI) (www.ppri.oebig.at).
  • Van Hout B. et al. (1994) Costs, Effects and C/E Ratios Alongside A Clinical Trial. Health Economics 3: 309-319.
  • Wake N. et al. (2000) Cost-Effectiveness of Intensive Insulin Therapy for Type 2 Diabetes: A 10-Year Follow-up of the Kumamoto Study. Diabetes Research and Clinical Practice 48(3): 201-210.
  • Walley T. (2004) Pharmacoeconomics and Economic Evaluation of Drug Therapies. In du Souich P. et al. (eds.) The IUPHAR Compendium of Basic Principles for Pharmacological Research in Humans, pp:67-75. Department of Pharmacology College of Medicine, University of California, USA.
  • WHO (2007) An Overview of the Rationale, Activities and Goals of WHO-CHOICE, http://www.who.int/choice/description/importance/en, 27.08.2007.
Toplam 47 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Hacer Özgen Bu kişi benim

Mehtap Tatar Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2007
Yayımlandığı Sayı Yıl 2007 Cilt: 10 Sayı: 2

Kaynak Göster

APA Özgen, H., & Tatar, M. (2007). Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum. Hacettepe Sağlık İdaresi Dergisi, 10(2), 109-137.
AMA Özgen H, Tatar M. Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum. HSİD. Nisan 2007;10(2):109-137.
Chicago Özgen, Hacer, ve Mehtap Tatar. “Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum”. Hacettepe Sağlık İdaresi Dergisi 10, sy. 2 (Nisan 2007): 109-37.
EndNote Özgen H, Tatar M (01 Nisan 2007) Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum. Hacettepe Sağlık İdaresi Dergisi 10 2 109–137.
IEEE H. Özgen ve M. Tatar, “Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum”, HSİD, c. 10, sy. 2, ss. 109–137, 2007.
ISNAD Özgen, Hacer - Tatar, Mehtap. “Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum”. Hacettepe Sağlık İdaresi Dergisi 10/2 (Nisan 2007), 109-137.
JAMA Özgen H, Tatar M. Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum. HSİD. 2007;10:109–137.
MLA Özgen, Hacer ve Mehtap Tatar. “Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum”. Hacettepe Sağlık İdaresi Dergisi, c. 10, sy. 2, 2007, ss. 109-37.
Vancouver Özgen H, Tatar M. Sağlık Sektöründe Bir Verimlilik Değerlendirme Tekniği Olarak Maliyet-Etkililik Analizi Ve Türkiye’de Durum. HSİD. 2007;10(2):109-37.