Objectives

The objective of this systematic review was to review the recommendations for the conduct of a budget impact analysis in national or organisational guidelines globally.

Methods

We searched several databases including MELDINE, EMBASE, The Cochrane Library, National Guideline Clearinghouse, HTA Database (International Network of Agencies for Health Technology Assessment), Econlit and IDEAS Database (RePEc, Research Papers in Economics). The OVID platform was used to run the search in all databases simultaneously. In addition, a search of the grey literature was also conducted. The timeframe was set from 2000 to 2020 with language of publication restricted to English.

Results

A total of 13 publications were selected. All the countries where financing of health is predominantly tax funded with public provisioning recommend a healthcare payer (government) perspective. However, countries where a healthcare payer includes a mix of federal government, communities, hospital authorities and patient communities recommend a complementary analysis with a wider societal perspective. While four guidelines prefer a simple cost calculator for costing, the rest rely on a decision modelling approach. None of the guidelines recommend discounting except the Polish guidelines, which recommend discounting at 5%. Only two countries, Belgium and Poland, mention that indirect costs, if significant, should be included in addition to direct costs.

Conclusions

The comparative cross-country analysis shows that a standard set of recommendations cannot be directly useful for all as there are contextual differences. Thus, budget impact analysis guidelines must be carefully contextualised in the policy environment of a country so as to reflect the dynamics of health systems.

中文翻译：

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卫生技术评估预算影响分析指南的系统文献回顾

目标

本系统审查的目的是审查在全球国家或组织指南中进行预算影响分析的建议。

方法

我们检索了多个数据库，包括 MELDINE、EMBASE、Cochrane 图书馆、国家指南信息交换所、HTA 数据库（国际卫生技术评估机构网络）、Econlit 和 IDEAS 数据库（RePEc，经济学研究论文）。OVID 平台用于同时在所有数据库中运行搜索。此外，还对灰色文献进行了检索。时间范围设定为 2000 年至 2020 年，出版语言仅限于英语。

结果

共评选出 13 篇论文。卫生筹资主要通过公共拨款获得税收资助的所有国家都建议采用医疗保健支付者（政府）的观点。然而，医疗保健支付方包括联邦政府、社区、医院当局和患者社区的国家建议采用更广泛的社会视角进行补充分析。虽然四个指南更喜欢使用简单的成本计算器进行成本计算，但其余指南则依赖于决策建模方法。除了波兰指南建议折扣率为 5% 外，没有任何指导方针建议打折。只有比利时和波兰这两个国家提到间接成本（如果很大）应包括在直接成本之外。

结论

比较跨国分析表明，一套标准的建议不能直接对所有人有用，因为存在上下文差异。因此，预算影响分析指南必须在一个国家的政策环境中仔细考虑，以反映卫生系统的动态。