对于预算影响分析的指导

Whilst guidance for budget impact analysis is required to ensure certain key considerations are addressed, the following guidance is intended to be flexible. By their very nature, budget impact analyses will differ according to the interests of the audience and the impact of the intervention. Therefore, detailed, prescriptive guidance would not be appropriate. What we are seeking to do is raise a series of issues which should be considered and addressed in developing a budget impact analysis.

预算影响分析指导需要确保某些关键的因素得到解决，下面的指导是为了使其可以变通。由于其本身的性质，预算影响分析将根据用户的利益和干预的影响做出差别。因此，详细的，规范的指导意见并不恰当。我们正在努力做的是考虑和制定一系列提高预算影响分析的处理方法。

In considering the desirable qualities of a budget impact analysis there are inevitably many common attributes one would hope to see in economic evaluations, or for that matter any type of health services research.As such, some of the points outlined in this section will also be present in guidelines for economic evaluation.

考虑到预算影响分析的完美品质难免会出现许多人们希望看到的在经济评价或者任何类型与保健设施相关研究方面的共同属性，这一部分所描述的观点也将在经济评价指导中出现。

5.1 Transparency 透明度

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Budget impact analyses should be transparent and allow for a clear understanding of all input as sumptions, assumed relationships between variables and resulting outcomes (e.g. disease state and hospital episodes). Since there is often a great deal of uncertainty around inputs to budget impact assessments (such as hospitalisation rates, the impact of new therapies on surgical rates, etc.), there is a strong possibility that the estimate will involve some degree of predictive modelling. It would be advisable to make any predictive model as interactive as possible to allow input variables to be adapted to reflect local treatment practices and thus ensure complete transparency.

预算案的影响分析应是透明的，大前提是允许清楚了解所有的输入，承担变量之间的关系和由此产生的结果（如疾病状态和医院事件）。由于经常有大量的不确定因素输入预算影响评估（例如住院率，新疗法对手术率的影响等等），这种估计极有可能涉及到预测模型的程度。这将适当的使预测模型尽可能的互动，尽可能使输入变量加以调整，以反映当局部里疗法，从而确保完整的透明度。

5.2 Clarity of Perspective 清楚的看法

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Economic evaluation of healthcare interventions usually adopts the classical cost-benefit analysis approach of a societal perspective. As such, many economic evaluations capture indirect costs, which are not the responsibility of the health service purchaser or may seek to address the impact on global healthcare budgets. The societal approach may be suitable for publicly funded health-care systems but even in these cases it will be unusual for health service purchasers to accrue any savings in non-health settings, or even beyond their own department. To overcome this,most budget impact analyseswill adopt a purchaser perspective.

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医疗保健干预的经济评价通常采用的一种社会的角度来看古典的成本效益分析方法。因此，许多经济评价捕获的间接费用，不属于买方责任的卫生服务，或可寻求解决全球卫生保健预算的影响。在社会的做法可能适合政府资助的卫生保健系统，但即使在这种情况下，将用于购买医疗服务的不寻常的累积非卫生机构，甚至超越他们自己部门的储蓄。为了克服这种情况，大多数预算的影响analyseswill采取买方的观点。?

The perspective adopted within a budget impact analysis must be clearly stated and the financial costs and savings considered consistent with this approach. Consideration should be given to the relevance of non-healthcare costs and benefits. For example, should reductions in potential productivity losses arising from the use of a smoking cessation intervention be included in the analysis?Most healthcare decision-makers would have little opportunity to take any advantage of such gains for society.

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Additionally, there should be clarity about whether the budget impact analysis predicts the impact on total budgets or is able to disaggregate the impact on particular purchasers. Whilst this may introduce some complexity into predictive modelling, ultimately it should produce results that are more applicable to healthcare decision-making.

中英文对照翻译