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首页> 外文期刊>Israel Journal of Health Policy Research >Do the equity-efficiency preferences of the Israeli Basket Committee match those of Israeli health policy makers?
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Do the equity-efficiency preferences of the Israeli Basket Committee match those of Israeli health policy makers?

机译：以色列篮子委员会的股权效率偏好是否与以色列卫生政策制定者的偏好相匹配？

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BackgroundPrioritization of medical technologies requires a multi-dimensional view. Often, conflicting equity and efficiency criteria should be reconciled. The most dramatic manifestation of such conflict is in the prioritization of new medical technologies asking for public finance performed yearly by the Israeli Basket Committee. The aim of this paper is to compare the revealed preferences of the 2006/7 Basket Committee’s members with the declared preferences of health policy-makers in Israel. MethodsWe compared the ranking of a sample of 18 accepted and 16 rejected technologies evaluated by the 2006/7 Basket Committee with the ranking of these technologies as predicted based on the preferences of Israeli health policy-makers. These preferences were elicited by a recent Discrete Choice Experiment (DCE) which estimated the relative weights of four equity and three efficiency criteria. The candidate technologies were characterized by these seven criteria, and their ranking was determined. A third comparative ranking of these technologies was the efficiency ranking, which is based on international data on cost per QALY gained. ResultsThe Committee’s ranking of all technologies show no correspondence with the policy-makers’ ranking. The correlation between the two is negative when only accepted technologies are ranked. The Committee’s ranking is positively correlated with the efficiency ranking, while the health policy-makers’ ranking is not. DiscussionThe Committee appeared to assign to efficiency considerations a higher weight than assigned by health policy-makers. The main explanation is that while policy-makers’ ranking is based on stated preferences, that of the Committee reflects revealed preferences. Real life prioritization, made under a budget constraint, enhances the importance of efficiency considerations at the expense of equity ones. ConclusionsIn order for Israeli health policy to be consistent and well coordinated across policy-makers, some discussions and exchanges are needed, to arrive at a common set of preferences with respect to equity and efficiency considerations.
机译：背景技术医疗技术的优先级排序需要一个多维的视图。通常，应该调和矛盾的公平性和效率标准。这种冲突最戏剧性的表现是优先考虑由以色列篮子委员会每年执行的要求公共财政的新医疗技术。本文的目的是将2006/7篮子委员会成员所揭示的偏好与以色列卫生政策制定者所宣称的偏好进行比较。方法我们将2006/7篮子委员会评估的18种被接受和16种被拒绝的技术样本的排名与根据以色列卫生政策制定者的偏好预测的这些技术的排名进行了比较。这些偏好是由最近的离散选择实验（DCE）引起的，该实验估计了四个股权和三个效率标准的相对权重。这七个标准对候选技术进行了表征，并确定了它们的排名。这些技术的第三项比较排名是效率排名，该排名基于获得的每QALY成本的国际数据。结果委员会对所有技术的排名与决策者的排名不符。当仅对接受的技术进行排名时，两者之间的相关性为负。委员会的排名与效率排名呈正相关，而卫生政策制定者的排名则没有。讨论委​​员会似乎比卫生政策制定者分配了更高的权重考虑效率问题。主要的解释是，尽管政策制定者的排名是基于既定的偏好，但委员会的排名却反映了所揭示的偏好。在预算约束下确定现实生活的优先级，以牺牲公平性为代价，提高了效率考虑的重要性。结论为了使以色列的卫生政策在各决策者之间保持一致和良好的协调，需要进行一些讨论和交流，以就公平和效率考虑达成一系列共同的偏好。

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