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Titolo:
WHY SOME HEALTH POLICIES DONT MAKE SENSE AT THE BEDSIDE
Autore:
ASCH DA; HERSHEY JC;
Indirizzi:
DIV GEN INTERNAL MED,317 RALSTON PENN CTR,3615 CHESTNUT ST PHILADELPHIA PA 19104 VET AFFAIRS MED CTR PHILADELPHIA PA 00000 UNIV PENN,WHARTON SCH PHILADELPHIA PA 19104
Titolo Testata:
Annals of internal medicine
fascicolo: 11, volume: 122, anno: 1995,
pagine: 846 - 850
SICI:
0003-4819(1995)122:11<846:WSHPDM>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
DECISION-ANALYSIS; INDIVIDUAL PATIENTS; PORTFOLIO THEORY; UTILITY; RISK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
26
Recensione:
Indirizzi per estratti:
Citazione:
D.A. Asch e J.C. Hershey, "WHY SOME HEALTH POLICIES DONT MAKE SENSE AT THE BEDSIDE", Annals of internal medicine, 122(11), 1995, pp. 846-850

Abstract

Cost-effectiveness analysis and other forms of decision analysis are becoming more common in the medical literature and are increasingly influential in the development of health policy. Nevertheless, many clinicians find it difficult to apply policies developed from these analyses to individual encounters with patients. We examine the assumptions behind these analyses and argue that the perspective they embody can make clinical strategies appear to be less risky in theory than they are at the bedside. We believe that this problem underlies the intuitiveconcern many physicians have about policy analyses and calls into question the value of these analyses in shaping clinical practice. These analyses aggregate the benefits and burdens of alternative interventions across different individual persons. Thus, overall population risk appears blunted, as it would in a diversified portfolio of stocks thatreact differently to financial forces or in a herd of cattle that react differently to veterinary interventions. The assumptions behind these analyses make sense if aggregate outcome is what matters, but not if one cares about each individual investment or animal. Because such aggregation tends to understate individual risk, when applied to human health policy, it may misrepresent the interests of patients and cannot be assumed to provide useful guidelines for decision making at the bedside.

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Documento generato il 01/12/20 alle ore 19:19:21