Table of Contents
Zvisarudzo zvegadziriro yezvoutano hazvitongova nyore. Zvinoda kudzikamisa mipimo inokwikwidzana yakadai sechikomberedzo, kushanda, kunaka, uye rusununguko rwomunhu oga mukupesana neganhuriro dzemari, mabasa, uye kuda kwezvamatongerwe enyika. Nokuda kwavadzidzisi navadzidzi vanodzidza muitiro wavose, kunzwisisa kushambadza kwomuzvarirwo kunokosha kunzwisisa chikonzero nei kunyange chinjo dzinosanosangurwa dzichiparira gakava nemiuyo isingakarirwi. Iyi nzvero yakakura inonzvera mugariro wemiitiro yezvoutano, mienzaniso chaiyoiyo yenyika, mibato yemibato yechenjere, mitoo yokurangarira, uye gadziriro dzetsika dzinotungamirira kuita chisarudzo.
Kurondedzera Mabhizimisi Mumutemo Wokutarisira Utano
Kuchinja mugadziriro yezvoutano mugariro umo kusarudza nzira imwe yechiito nenzira isingadzivisiki kunobatanidza kurasikirwa nebetsero dzingagona kuva dzakawanwa nomumwe. Izvi zvisarudzo zvinoitika pamwero uri wose(kubva pamutemo wenyika kusvikira kumigove yemari yezvipatara yomunzvimbomo. Kuoma kwemitengo ndekwokuti zvipfuyo zvinoguma nepo zvinodikanwa zvoutano zvisingagumi. Vagadziri vemitemo vanofanira kuita zvisarudzo izvo zvinoparira vakundi navakundi pakati pezvizvarwa pakati pevagari vemo, maindasi, uye zvizvarwa.
Masimba Anokosha Emabhizimisi
- mutengo unobatanidza: Kufukidzwa kungawedzera mari inobhadharwa yavose kana kuti yeinishuwarenzi, nepo matanho okuderedza ndyiko anowanzoderedza kusvika kwamapoka asina dziviriro.
- yorunako. Kushanda: Ukuru, tarisiro yomunhu oga inowanzoda nguva yakawanda nemari, zvingaderedza simba regadziriro yezvinhu.
- Kugadzirwa kwechimushongo. Kubudirira: Kukurudzira kugadzirwa kwemirimo mitsva nemuchina zvinogona kukwidza mitengo; kudzora mutengo kungaderedza R& D kurudziro.
- Zvinosarudzwa nomunhu. Zvakanaka zvinounganidzwa: Kuda kufanana nezvinodikanwa zvokudzivirira kana kuti mirau yeinishuwarenzi inoganhurira rusununguko rwomunhu oga nokuda kwoutano hwavagari vemo.
- Tsvene-Term vs. Kubuda kwePromo Refu: Kudzivirira kunopa mari yasara makore gare gare, asi zviverengero zvezvamatongerwe enyika zvinoda miuyo yapakarepo.
Zvinhu Zvinokosha Zvinopesvedzera Mabhizimisi
Masimba akawanda anobatsira pakuongorora kugadzirwa kwezvinhu uye kugadzirwa kwezvinhu zviri pedyo nepedyo kunobatsira kuti zvisagadzirwa zvakanaka.
Kubudirira Kwemabhangi uye Kuoma Kwemabhangi
Mitengo yezvoutano munyika yose inotarisana nendyiko dzinokwira nenhamba dzenhamba dzevakwegura, mitoro yehosha isingaperi, uye ruzivo rwezvokurapa runodhura. Hurumende inoronga (hwungava kupfurikidza nemitero kana kuti mutengo weinishuwarenzi) haisati iri isina kuganhurirwa. Sangano reCernation for Economic Co-operation and Development (OECD) rinocherekedza kuti ndyiko dzezvoutano dzinopfuura 9% dzeGDP munyika dziri mitezo paavhareji, dzinosiya nzvimbo shoma nokuda kwezvimwe zvinhu zvinokosha. Vagadziri vemikoro vanofanira kusarudza kuti vatsaurire sei kuzvipatara, tarisiro huru, utano hwavose, kana kuti kunzvera, kazhinji kupfurikidza nokuwana mari kubva kune imwe nzvimbo kuti itsigire imwe.
Mamiriro Ezvinhu Ezvamatongerwe Enyika Nemasangano
Mamiriro ezvamatongerwe enyika anosarudza zvikuru kuti ndedzipi dzinobvira. MuUnited States, vatsigiri vakavhara kazhinji kazhinji chinjo huru dzakadai sechisarudzo chavose kana kuti chinyorwa chavose. Mumiitiro yeparamende seUnited Kingdom, chinjo dzinogona kuitwa nokukurumidza zvikuru, asi dzichiri kutarisana nechishoro kubva kusonganiro dzezvokurapa, mapoka emurwere, uye zvinobudisa nhau. Inhiko dzinobatanidzawo: masangano ehurumende anoparadzira chiremera pakati pehurumende dzenyika nedzisiri dzamarudzi ose, achigadzira mirwi yekurukurirano nedzokubvumirana pane zvisina kufanira.
Mafungiro Evanhu uye Tsika Dzavanoda
Kariro dzavagari vemo pamusoro petarisiro dzoutano(nzi vanoirangarira sechinhu chakarurama kana kuti chinhu chinosarudzwa. Nzvero dzinoitwa neKaiser Family Foundation dzinoratidza nguva dzose kuti vaAmerica vanoisa ngwariro dzoutano panzvimbo yakakwirira asi havabvumirani pamusoro pebasa rehurumende. Murangariro wavose unogona kumanikidza vaiti vemitemo kuchengeta vakakurumbira asi mupurogiramu dzisingashandi kana kuti kurega matanho anoderedza mari anorangarirwa seanogoverwa.
Uchapupu uye Kusanyatsoziva
Gadziriro youtano inofanira kuva yakavakirwa paufakazi nenzira yakanangana, asi ufakazi hunowanzova husina kukwana, hunorwisana, kana kuti hunononoka kusvika. Somuenzaniso, tapuro dzenhambo refu dzegadziriro yokupinza mirimo itsva dzingatora makore kuti ive yakananga. Vagadziri vemiitiro vanofanira kuita pasina chokwadi, vachiita kutengeserana pahwaro hwamashoko asina kukwana.
Mienzaniso Yenyika Chaiyoiyo Yemabhizimisi Ezvoutano
Zviitiko zvakarongwa zvinojekesa kuti kutengesa kunoshambadza sei mukushanda.
Muenzaniso 1: Kufukidza Nokumirira Nguva Munyika Yose
Nyika dzinowana purovhinzi inodokusvika mupasi rose .Nkakawanda dzinogamuchira nguva refu dzakamirira gadziriro dzokusarudza sechibvumirano chekumirira. Canadian Institute for Health Information inoshuma kuti vanobudisa nhau vanomirira nguva nokuda kwokutsiva chiuno kubva pa20 kusvika ku30 zvichitsamira paruwa. MuUnited States, uko kubhadharwa kusiri kwesero rose asi nguva dzokumirira kazhinji kazhinji dzinova pfupi nokuda kwechinosarudzwa, kutengeswa kunochinjwa: kusvika kuri nani nokuda kwavanhu vanobhadharwa pakurasikirwa ne 26 mamirioni (Cens Bureault). Vagadziri vemikoro vanofanira kusarudza kuti ndeipi inoparadzirwa yokupinda munyika yacho inogamuchirwa inogamuchirwa.
Muenzaniso 2: Kushandiswa Kwezvinodhaka Zvinopiwa Nomushonga
Nhamburiko dzokuderedza mitengo yemirimo nejekiseni , interneclagement, kana kuti kupinza munyika jekiseni . Yakatarisana nokutengeswa kwemibereko yemakambani emishonga ingagona kuderedza mhindu yemakambani emishonga neR&D. Nzvero 2021 muHwedzero yeHealth yakawana kuti kudzorwa kwemitengo muEurope hakuna kumisa ganhuriro yemipikicha yeUS kunoramba kuri nzvimbo yemhindu inokosha. Vagadziri vemiitiro vanofanira kudzikanisa mari nokukurumidza munhambo refu yokurapa.
Muenzaniso 3: Kukura Kwematereheya uye Kutarisirwa
Mukati medenda reCOVID-19, kushandisa translation kwakaputika. Costandoff inobatanidza kuvadziko nerokupindwa nakwo (zvikurukuru kuvarwere vomumaruwa) mukupesana neitiro hanya pamusoro pokururama kwokunzvera, kupfuurira kwetarisiro, uye mativi amanani. Michare nevezvemishuwaredzi vanorerutsa mitemo inobhadharwa kwechinguvana, asi sezvo vaiti vemitemo vanorangarira wedzero yechigarire, vanofanira kuyera betsero dzeshanyo dzinodokuva dzinorwisana nengozi yokushandisa nokupotsa kunzvera.
Muenzaniso 4: Utano Hwavose Hunorwisana Nerusununguko Rwomunhu Mumwe Nomumwe
Mukati medenda reCOVID-19, kuraira kwokuvhara mask, kuvhara, uye zvinodikanwa zvenhomba zvakaparira kurukurirano inotyisa. Costandoff yakanga yakajeka: ganhuriro dzinoraira kupfuudzwa kwevhairasi kunodzorwa (kudzivirira zvipatara nokuponesa upenyu) asi dzakaparirawo kuvadziko yemari, migariro yendangariro, uye kudzongonyedzwa kworusununguko rwomunhu oga. Nyika dzakasiana - siana namasangano zvakaisa mutsetse pamapfundo akasiana - siana, zvichizivisa kusabvumirana kwoukoshi.
Basa Revatambi Mumafashoni
Masangano evane chikwereti haaiti zvokuchinja - chinja, asi anotoita kuti vanhu vasanyanya kukoshesa utano hwavo.
Vakuru Vakuru Vehurumende Navatungamiriri
Vakuru vakuru vanoumba mitemo, hurumende, uye mapurogiramu emari, uye mitemo. Vanofanira kuzvidavirira kuvavhoti uye kazhinji kazhinji vanofanira kuita zvisarudzo zvematongerwe enyika, kunyange kana ufakazi huchikarakadza nzira yakasiana. Somuenzaniso, Dare reUnited States rakaramba rarambazve gadziriro inobhadhara mumwe pasinei zvapo noufakazi hunobva kune dzimwe nyika dzendyiko dzakaderera dzehurumende uye dzinobhadharwa pasi pose.
Health Care Abaridzi (Mahospital, Vanachiremba, Vakoti)
Varidzi vanodzorwa zvakananga nezvisarudzo zvemitemo. Vangada mari inodzorwa nemari inobhadharwa, mitoro mishoma, kana kuti kupfuudzwa kwakawedzerwa kunounza mari yakawanda. Uzvimiriri hwavo nefariro dzemari zvinogona kupesana nevavariro dzemari inotengwa. Somuenzaniso, kufambiswa kuenda kumari inobhadharwa mari yakakwirira (inodzosa kumiuyo yemurwere) kunotarisana nokusagona kudzorerwa mari kubva kuvaridzi vemari vanotya kurasikirwa nemari.
Kushanda Kweinishuwarenzi uye Kuronga Kutarisira
Varidzi vemishuwarenzi vepachivande vangashora zvisarudzo zvinotyisidzira bhizimisi ravo. Panguva imwe cheteyo, vane unyanzvi hwokutarisira ngozi uye kushandisa kunogona kuzivisa mutemo.
Varwere, Mhuri, uye Mapoka Okurera Vana
Murwere akadai seAmerican Cancer Society kana kuti National Alliance on Mental Illness(-pash nokuda kwokuwana kurapa chaiko, kunzvera, kana kuti tarisiro yakavandudzwa. Mirangariro yavo inogona kuunza kurumidziro yetsika asi ingadawo fariro dzakaganhurirwa kupfuura migove yavose. Somuenzaniso, nhimbe dzemirimo yenherera ine mari yakawanda dzinogona kutungamirira kukushandisa mari yakawanda nokuda kwavagari vemo vaduku, kutsausa mari kubva kuzvirongwa zveutano zvavose.
Michina Yemishonga Neyekurapa
Vavariro yavo yemhindu inoparira mavambo matsva asi inogonawo kutungamirira kukukwira kwemitengo uye kutengeserana kwougandanga. Tracoff inomuka apo vagadziri vemitengo vanorangarira kudzorwa kwendyiko kana kuti kuchinja kusingachinji kungaderedza mhindu uye, zvingangova, kubudirira mune ramangwana.
Kudzidza, Vatsvakurudzi, uye Kufunga
Zvisinei, kupesvedzera kwavo hakuna kunanga, uye mazano avo angasateererwa kana achirwisana nezvido zvine simba.
Matende Okubvisa Mabhizimisi
Kuti vaongorore zvirongwa zvokutengesa, vagadziri vemitemo nevaongorori vanoshandisa nzira dzakasiyana - siyana.
Kuongorora Kunobhadhara (CEA)
CEA itsanangudza migumisiro youtano (muchib., yakagadziridzwa zvakanaka makore oupenyu, QALY) yakawanwa pamutengo mumwe nomumwe. Inoshandiswa nemiviri seNational Institute for Health and Care Excelllence (NICE) kusarudza kuti kurapa kupi kwokutsigira. Vatsoropodzi vanoti CEA anogona kuderedza zvinodiwa nevanhu vane zvirwere kana kuti urema husingawanzowaniki. Kushambadza kuri pakati pounyanzvi hwezvishandiso zvemashandiro uye mipimo yenzanga.
Kuongorora Ndyiko Inotengwa (CBA)
NHAU dzokushandisa utachiona hwose, kubatanidza rufu namarwadzo, kuti zviwane betsero yenzanga. Kunonzwika zvikuru asi kunomutsa nharo mutsika. Miitiro mishomanene youtano inotsamira chose chose paCBA nemhaka yokuti kuisa ukoshi hwedhora paupenyu kunokakavadzana.
Kuongorora Zvisarudzo Zvakawanda (MCDA)
MCDA inobatanidza mitaro mizhinji(*, kusagamuchirika, kugamuchirwa kwezvamatongerwe enyika, uye tapuro dzoutano) kupfuura bedzi ndyiko ne QALY. Inobvumira vachengeti vemipimo kuyera nenzira yakasiana, inoyera kutengeserana.
Michina yeFramesity Utilitarianworsts
Mitauro yavashandi inowedzera betsero yose youtano, ingakuvadza avo vane utano hwakaipa zvikuru. Mirangariro yapamberi penzvimbo inoisa pakutanga zvakaipisisa, kugamuchira betsero yakaderera yetsika nokuda kwetsika huru. Nharo pamusoro pomuitiro woutano kazhinji kazhinji dzinoratidzira iyi mirangariro yetsika inokwikwidzana.
Zvirongwa Zvinoshanda Zvokutengesa
Vagadziri vemitemo vanogona kushandisa nzira dzokuita nadzo kuti pave nokutengesa kunopenya zvikuru uye kunoziviswa.
Dzvinya rakajeka
Kushandisa matare ezvokunyora ane mifanikiso yakasiana - siana kunogona kuratidzira mipimo inokwikwidzana ndokuvandudza kuva pamutemo. Somuenzaniso, Health Evince Review Commission yeOregon inobatanidza vanachiremba, vatengi, uye vagadziri vemitemo kugadza Medicaid pamberi pokuitwa.
Kuedza Nokuongorora Kunokwezva
Gadziriro dzemotokari nedzinonyorwa dzinobvumira kuedzwa kwemitemo pamwero muduku pamberi pokuitwa kwakazara. Kuchinjana kweinishuwarenzi yakavakirwa pahurumende kwakatangwa kwamakore anoverengeka, kuchigonesa gadziridzo dzakavakirwa pamiuyo yapakuvamba.
Kubatanidzwa Pachena uye Kushatisa Kwechisimba
Kubatanidza vagari vomumataundi nehoro, nzvero, uye mabudiro anogona kuwiriranisa muitiro nezvinokosha zvavose.Izvi zvinobetsera vaiti vemiitiro kunzwisisa kuti ndechipi chinotengesa vanhu chinodisa kugamuchira.
Kugadzira Zvishandiso Zvekusarudza Zvakarongwa
Mabhaisikopo akadai semiti yechisarudzo, kuronga zviitiko, uye "kurapa kwemichina" anobetsera kuronga migumisiro isati yaita. Izvozvi zvinobetsera zvikuru munzvimbo dzine mipambo yakatemwa uko zvikanganiso zvinodhura.
Kutengeserana Mumagadziriro Outano Akaenzana
Kuongorora nyika dzakasiyana - siyana kunoratidza kuti kutengesa kunopedzwa sei mutsika dzakasiyana - siyana uye mune zvematongerwe enyika.
Mubhadhari Mumwe (Canada, Taiwan)
Tradoff: Kubhadharwa kwenyika yose nendyiko dzakaderera dzehurumende, asi nguva dzokumirira tarisiro inosarudzwa nokubatanidzwa kwechikamu kwapachivande kwakaganhurirwa. Varwere vangatsvaka tarisiro kunze kwenyika kana kuti kubhadhara basa rinodzorwa nokukurumidza.
Muenzaniso weBismark (Germany, Japan)
Tradoff: Inishuwarenzi yakavakirwa pavashandi inobhadharwa zvikuru asi inoshanda zvakaoma. Ndyiko dzinodzorwa nepurogiramu dzinodzorwa nemirau inodzorwa, bva mari inogona kuva yakakwirira nokuda kwavashandi vanotambira mari shoma.
Mufananidzo weberidge (UK, Spain)
Tradeff: Mitero yakarongerwa, inogoverwa pachena kutarisira kunovimbisa kusasarura asi kunotarisana neganhuriro dzemari yemari neganhuriro dzenhambo nenhambo. Kumirira ndaza nokuda kwemiitiro isingadzorwi inhau isingagumi.
Kubva kuPocket Model (nyika zhinji dzinosvika pasi)
Tradeff: Varombo havakwanisi kuwana mari yakawanda, asi vanochinja - chinja uye vasinganyanyi kurapwa.
Tsika Dzevatengesi: Zvisarudzo Zvakaoma Mumutemo Woutano
Pakupedzisira, kutengesa kunosanganisira kufunga nezvetsika dzisiri dzokuongorora kwounyanzvi.
Kudzikamisa Musi Une Mutengo.
MuUS, kugoverwa kunoitika zvikurukuru nomutengo wakadai sehwunogona kubhadhara inishuwarenzi kana kuti mari inotengwa; avo vasingagoni, vanononoka kana kuti vanorega kurapwa. MuCanada neUK, kugovera kunoitika nenguva yokumirira (56) munhu ari wose anogona kutarisirwa, asi anomirira nguva refu nokuda kwemimwe mibato. Ndeipi iri mirefu zvikuru? Hapana mhinduro yavose; inotsamira pamipimo yetsika yenzanga pamusoro pokuenzana uye kuenzana.
Kudzikamisa Kwezera
Mimwe mitemo inoganhurira chose chose kana kuti zvakajeka kurapa kunodhura nokuda kwavakwegura (sezvinei, ganhuriro dzezera nokuda kwokuisirwa nhengo dzomuviri kana kuti tarisiro yakakomba). Costandoff iri pakati pokuwedzera makore oupenyu anoponeswa (varwere vaduku) uye kuremekedza ukoshi hwakaenzana hwoupenyu hwose. zvisarudzo zvakadaro hazviwanzoitwa pachena nemhaka yokutapurwa kwezvamatongerwe enyika.
Kuisa Nguva Yokutanga Muzvinhu Zvisina Kutsarukana
Mukati meCOVID-19, mitemo yetsika yetatu yakagovera zvakajeka zviwanikwa zvishoma zvakadai sezvinopa mhepo uye mibhedha yeICU. Iyi mitemo yakaisa miganhu yakakarira betsero yokupukunyuka, kazhinji kazhinji ichibvisa vakuru navane coorbibitation. Tsvene inobvisa miuyo mitsva mizhinji. Kurapa murwere mumwe nomumwe zvakaenzana.
mhedziso
Kunzwisisa kufambiswa kwemashoko mugadziriro yezvoutano hakusi kudzorwa kwedzidzo; iko musimboti wezvidzoreso zvinoshanda, tsika. Chisarudzo chiri chose chemiitiro chinodzivisa mikana yokutsiva ndokuisa ndyiko pamamwe mapoka apo vanobetsera vamwe. Nokuda kwavadzidzisi navadzidzi, kuziva mutauro nenjere dzezvokutengesa zvichagonesa kunzvera kwakawanda uye kuva nounhu hwakasiyana. Sezvo gadziriro dzezvoutano dzinotarisana nesvupinjo dzenzviwachi, budiriro dzeruzivo rwokugadzira zvinhu, uye dzvinyiriro dzemifungo, mano okuziva, kushambadza, uye kukurukurirana kuchaita kuti zvisaramba zviri madikanwa. Nhakaro hazvisi kubvisa kushambadza kushatsa kushambadza kushatsa.