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      Evaluación económica en salud y toma de decisiones en el contexto sanitario cubano Translated title: Economic assessment in health care and the decision-making in the health care context

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          Abstract

          Objetivo: identificar cuáles son los factores que fortalecen y los que limitan el adecuado uso de las evaluaciones económicas en función de la toma de decisiones en el contexto sanitario cubano. Métodos: se seleccionó un conjunto de profesionales vinculados a la toma de decisiones en diferentes ámbitos del Sistema Nacional de Salud. Se realizaron grupos focales para cada nivel identificado y entrevistas de profundidad a directivos, médicos, profesores e investigadores escogidos para conocer sus criterios al respecto. Resultados: se encontraron factores de carácter práctico, metodológico y administrativo que fortalecen y otros que limitan el desarrollo de la evaluación económica en el país. Conclusiones: se propone un conjunto de acciones para fortalecer el uso de la evaluación económica en salud en el proceso de toma de decisiones en Cuba.

          Translated abstract

          Objective: to identify the factors that strengthen and those factors that limit the adequate use of economic assessment as a function of the decision-making process in the Cuban health care system. Methods: there was selected a group of professionals linked to the decision-making process at various contexts of the national health care system. Focal groups for each identified level were organized in addition to making in-depth interviews to chosen managers, physicians, professors and researchers to find their criteria on this issue. Results: practical, methodological and administrative factors that either strengthen or limit the development of economic assessment nationwide were identified. Conclusions: a number of actions were put forward to strengthen the use of economic assessment in health in the decision-making process in Cuba.

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          Most cited references48

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          Spanish recommendations on economic evaluation of health technologies.

          The economic evaluation of health technologies has become a major tool in health policy in Europe for prioritizing the allocation of health resources and the approval of new technologies. The objective of this proposal was to develop guidelines for the economic evaluation of health technologies in Spain. A group of researchers specialized in economic evaluation of health technologies developed the document reported here, following the initiative of other countries in this framework, to provide recommendations for the standardization of methodology applicable to economic evaluation of health technologies in Spain. Recommendations appear under 17 headings or sections. In each case, the recommended requirements to be satisfied by economic evaluation of health technologies are provided. Each recommendation is followed by a commentary providing justification and compares and contrasts the proposals with other available alternatives. The economic evaluation of health technologies should have a role in assessing health technologies, providing useful information for decision making regarding their adoption, and they should be transparent and based on scientific evidence.
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            A systematic review of the use of economic evaluation in local decision-making.

            In view of resource scarcity, decisions have to be made on the optimal allocation of resources and one possible option in health care is economic evaluation. Little is known, however, about the use of economic evaluation. The objectives of this review were to assimilate the empirical evidence on this topic, discuss the main findings, and explore the possible need for further work needed in this area. A total of 40 studies were included in the review from a range of countries. A systematic search strategy was used and data from papers were extracted in a systematic way. Pharmacists and clinicians in the US are the most frequently sampled group and postal surveys was the most commonly used method. Despite some positive findings, in most cases there appear to be obstacles to the extensive use of economic evaluation in decision-making. Obstacles can be linked to three factors: (1) institutional and political; (2) cultural; (3) methodological factors associated with economic evaluation itself. There has clearly been an increase in the use of economic evaluation over time, especially in the UK, whereas the US appears to have a deep rooted disfavour of the approach. However, there is still little known about the exact influence of economic evaluation at the local level. Whilst work conducted to date has been valuable in providing information about use and barriers to use, further qualitative work is needed to enrich and explain some of the findings from this review.
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              Guía metodológica para la evaluación económica en salud: Cuba, 2003

              Los objetivos de la Guía Metodológica para la Evaluación Económica en Salud en Cuba son 2, el primero consiste en disponer de un conjunto de orientaciones que coadyuven a garantizar la transparencia, comparabilidad, validez y credibilidad de los resultados de este tipo de investigaciones. El segundo objetivo persigue facilitar la realización de evaluaciones económicas a personal de menos experiencia en el tema. Para la elaboración de la Guía Metodológica se dieron los siguientes pasos: revisión bibliográfica y documental sobre las tendencias de la evaluación económica en el mundo, autores principales y guías metodológicas que se aplican en diferentes países. Seguidamente se realizaron grupos de consenso para perfeccionar la primera propuesta, con la participación de estudiantes y profesores de la Maestría de Economía de la Salud de la Escuela Nacional de Salud Pública (ENSAP), Vicedirectores Económicos provinciales y especialistas del Área de Economía del Ministerio de Salud Pública (MINSAP). Más adelante la Guía se revisó por expertos nacionales e internacionales y por último se reelaboró la versión final. Se propone realizar una revisión de la guía publicada, en enero del 2005, para su perfeccionamiento a partir de las experiencias acumuladas en su aplicación. La Guía está conformada en 4 partes. La primera de ellas toma la forma de un esquema de los pasos que se deberán seguir en una evaluación económica. Se espera que sirva de ayuda a quienes se enfrentan a esta tarea sin contar con gran experiencia en su aplicación. A continuación se presenta un conjunto de recomendaciones que de hecho constituyen el centro de la Guía, las cuales aparecen como referencias en el esquema antes mencionado. La tercera parte es un modelo resumen para la presentación del resultado final de la evaluación económica. Finalmente, se ofrece un glosario de conceptos y términos útiles para la aplicación de la evaluación económica. Hay que insistir en que se está en presencia de una Guía y no de Normas Metodológicas. Esto es, se trata de recomendaciones y no de directivas
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                Author and article information

                Journal
                rcsp
                Revista Cubana de Salud Pública
                Rev. cub. salud pública
                Centro Nacional de Información de Ciencias Médicas (La Habana, La Habana, Cuba )
                0864-3466
                1561-3127
                June 2012
                : 38
                : 2
                : 253-262
                Affiliations
                [01] La Habana orgnameEscuela Nacional de Salud Pública Cuba
                [02] La Habana orgnameCentro para el Desarrollo de la Farmacoepidemiología Cuba
                [03] La Habana orgnameInstituto Nacional de Higiene, Epidemiología y Microbiología (INHEM) Cuba
                Article
                S0864-34662012000200008 S0864-3466(12)03800208
                10.1590/s0864-34662012000200008
                7354cee5-7b91-4ace-8fd7-6c76c940355f

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 08 December 2010
                : 28 November 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 10
                Product

                SciELO Public Health

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                INVESTIGACION

                Evaluación económica,health economics,decision-making,toma de decisiones,economía de la salud,Economic assessment

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