Weale Preventative Medicine Data and Programmes

This paper discusses the problem of reflecting the impact of new and improvedmedical treatments including preventative public health measures in measures ofhealth services gross output and in the prices of medical and public health services.Both the treatment in mainstream national accounts and in a satellite healthaccount are considered. An algebraic framework is set out. In the mainstreamnational accounts the new service is initially priced at its reservation price definedwith reference to gains in quality-adjusted life years (QALYs) and reductions incosts. Withdrawn services are similarly treated. In the satellite account, theincrease in QALYs plus cost savings less costs incurred are measured relative to theQALYs generated by medical services net of costs of production. The frameworkis applied to the UK’s Diabetes Prevention Programme. The impacts on bothprices and volumes of this are shown to be small.

本文探讨了如何在医疗服务总产出测算及医疗与公共卫生服务价格中反映包括预防性公共卫生措施在内的新型及改良医疗手段影响的问题。研究同时考量了主流国民账户（mainstream national accounts）与卫生卫星账户（satellite health account）中的处理方式，并构建了一个代数框架。在主流国民账户中，新服务的初始定价为保留价格（reservation price），该价格参考质量调整生命年（QALYs）的增加及成本的降低来定义；已退出服务的处理方式与此类似。在卫生卫星账户中，测算的是质量调整生命年的增加量加上成本节约额再减去已发生成本，该结果与医疗服务产生的、扣除生产成本后的质量调整生命年相关联。该框架被应用于英国糖尿病预防计划（UK’s Diabetes Prevention Programme），结果显示其对价格及数量的影响均较小。