ABSTRACT

Introduction

As well as improving population health, promoting equity in health is one of the key goals of health policy in low- and middle-income countries (LMICs). However, it is less clear how equity is defined, or how it may impact on resource allocation decisions. We investigated the degree to which health inequalities have been considered in economic evaluation of health interventions in LMICs, and what demographic or socioeconomic characteristics were used to define equity relevant subgroups.

Areas covered

We reviewed publications since 2010 from three main databases following the search strategy developed by including the key terms ‘health inequalities/health disparities/health equity,’ ‘economics’ and ‘low- and middle-income countries’ in the title or abstract. Twelve studies were identified, mainly focusing on interventions for the more vulnerable groups such as children and women.

Expert opinion

Some attempts have been made to assess interventions’ impact on health inequality and there is increasing interest in evaluating it, although research in this area is lacking. Population subgroups highlighted in the included studies were those differing in socioeconomic status. Most studies reported the results across subgroups to illustrate inequality impact, and the newly developed methods, extended cost-effectiveness analysis and distributional cost-effectiveness analysis, have also been applied.

中文翻译：

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将健康不平等的影响纳入中低收入国家的经济评估：系统评价

摘要

介绍

除了改善人口健康，促进健康公平是中低收入国家 (LMIC) 卫生政策的主要目标之一。然而，公平是如何定义的，或者它如何影响资源分配决策，还不太清楚。我们调查了在中低收入国家健康干预的经济评估中考虑健康不平等的程度，以及使用哪些人口或社会经济特征来定义与公平相关的亚组。

涵盖的领域

自 2010 年以来，我们通过在标题或摘要中包含关键术语“健康不平等/健康差异/健康公平”、“经济学”和“低收入和中等收入国家”而制定的搜索策略审查了自 2010 年以来来自三个主要数据库的出版物。确定了 12 项研究，主要侧重于针对儿童和妇女等更弱势群体的干预措施。

专家意见

已经进行了一些尝试来评估干预措施对健康不平等的影响，并且人们对评估它的兴趣越来越大，尽管缺乏这方面的研究。纳入研究中强调的人群亚群是社会经济地位不同的人群。大多数研究报告了跨亚组的结果以说明不平等的影响，并且新开​​发的方法，扩展成本效益分析和分配成本效益分析也得到了应用。