Public preferences for allocating health system resources in Canada: a systematic review
Notice bibliographique
Résumé
BACKGROUND: Conventional economic evaluations are based on the principle of health maximization. However, this approach does not consider societal preferences to prioritize health care for certain social groups and health conditions, and the public concern over health disparities. In recent years, equity-informative economic evaluation methods have been developed to incorporate societal concerns over for health inequities. These methods use quantitative evidence based on preference elicitation exercises to inform allocation of health system resources. OBJECTIVE: To systematically review Canadian studies that quantify public preferences for allocating health care resource across social groups and health conditions. METHODS: Three electronic databases were searched on January 1st, 2024: Ovid Embase, Ovid MEDLINE, and EBSCO EconLit. In addition, the reference lists of relevant papers were also scanned to detect any other suitable studies. The systematic review included studies that met the following criteria: they were survey-based, sampled Canadian residents and involved preference elicitation, where participants made decisions about resource allocation or responded to hypothetical scenarios about redistributing lifetime health. Qualitative studies and non-preference-based studies were excluded. Risk of Bias was assessed using the CLARITY Group's tool for evaluating cross-sectional surveys of attitudes and practices. Two reviewers conducted screening, full-text review, and data extraction. Studies were narratively synthesized. RESULTS: Eight studies, with 8,969 participants, were identified that investigated public preferences for prioritizing health care in relation to age, income, disease rarity, and baseline health. Age-related preferences tended to favor children and younger patients over older patients. Aversion to socioeconomic-related health inequality was heterogeneous and was associated with respondent characteristics. No clear preference was found for treatments for rare diseases over common conditions, or for baseline quality of life and life expectancy. Two studies exposed participants to moral reasoning exercises that led to slightly lower levels of preference for prioritization of specific conditions or groups. CONCLUSION: While the identified studies in the review were heterogenous, they provide some evidence supporting the prioritization of healthcare resources for children and younger patients over older patients. There is limited Canadian evidence on societal values related to health inequity associated with socioeconomic status, sex/gender, race/ethnicity, and other social determinants of health. Future research can help bridge this gap.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,031 | 0,130 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,008 | 0,007 |
| Bibliométrie | 0,018 | 0,027 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,006 | 0,003 |
| Science ouverte | 0,003 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».