我国ICER阈值理论和实证研究进展及启示  

Progress of Theoretical and Empirical Research on ICER Thresholds in China and Its Enlightenment

作　　者：张晨曦 王海银[2] 金春林[2] Zhang Chenxi;Wang Haiyin;Jin Chunlin(Shandong Second Medical University,Weifang,Shandong,261053,China;不详)

机构地区：[1]山东第二医科大学公共卫生学院,山东潍坊261053 [2]上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海200040

出　　处：《中国卫生经济》2024年第11期32-34,40,共4页Chinese Health Economics

基　　金：上海市科委软科学研究基金项目(SYXF012168069);上海市2021年度“科技创新行动计划”自然科学基金项目(21ZR1458800)。

摘　　要：目的:为探索适用于我国ICER阈值的测算方法和合理估值提供建议。方法:运用文献分析方法,汇总分析我国ICER阈值的理论和实证研究,发现研究共同点和争议点,比较分析意愿支付法和机会成本法等获得的阈值。结果:我国ICER阈值理论研究主要集中在测算方法、健康产出指标、公平性等方面,对阈值特征尚存有争议。实证研究中,基于医保需方角度的意愿支付法应用最广泛,但该方法测得的阈值结果差别较大;基于医保供方角度的机会成本法测得的阈值低于基于需方角度获得的阈值。结论:仍需讨论确定适用于我国的阈值特征和两个角度结合互补的测算方法框架体系,并且将测算方法标准化和规范化,同时根据人群偏好、疾病严重程度等设置多层次阈值,以兼顾经济性和公平性。Objective:To provide suggestions for exploring the ICER threshold's calculation method and reasonable estimation in China.Methods:It summarizes the consensus and analyze the disputes on thresholds in China based on theoretical and empirical research by literature review,compares the thresholds derived from willingness to pay versus opportunity cost methods.Results:Theoretical researches on threshold of China mainly focus on method for calculation,health output index,and health equity,etc.The controversy persists over the threshold's characteristics.The health care demand-side perspective wllingness-to-pay method was the most widely used in the empirical studies,but the results of the thresholds measured by this method varied widely;the thresholds measured by the health care supply-side perspective opportunity cost method were lower than the thresholds obtained from the demand-side perspective.Conclusion:It is still essential to discuss the threshold's characteristics and establish the methods framework complementing both demand and supply side for Chinese health insurance,and to standardize and normalize the measurement methods,as well as to set up multi-level thresholds according to the preferences of the population,the severity of the disease,and so on,in order to take into account both economy and equity.

关 键 词：ICER阈值 实证研究 意愿支付法 机会成本法 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R95