{"id":1045,"date":"2008-10-03T13:41:39","date_gmt":"2008-10-03T17:41:39","guid":{"rendered":"http:\/\/gillesenvrac.ca\/carnet\/?p=1045"},"modified":"2008-10-03T13:41:39","modified_gmt":"2008-10-03T17:41:39","slug":"evaluations-dimpact-et-de-cout","status":"publish","type":"post","link":"https:\/\/gillesenvrac.ca\/carnet\/2008\/10\/evaluations-dimpact-et-de-cout\/","title":{"rendered":"\u00e9valuations d&#039;impact et de co\u00fbt"},"content":{"rendered":"<p>L&rsquo;\u00e9valuation des co\u00fbts associ\u00e9s \u00e0 la sant\u00e9 doit d\u00e9passer les seuls frais de l&rsquo;intervention imm\u00e9diate, les seuls frais du r\u00e9seau de la sant\u00e9 et inclure les retomb\u00e9es sur les autres \u00ab\u00a0syst\u00e8mes\u00a0\u00bb : ch\u00f4mage; criminalit\u00e9; \u00e9ducation&#8230;  Une question soulev\u00e9e <a href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/337\/sep29_1\/a1204\">dans le British Medical Journal<\/a> cette semaine. L&rsquo;article de Drummond et al. (cet article n&rsquo;\u00e9tant pas un r\u00e9sultat de recherche mais plut\u00f4t un \u00e9ditorial, n&rsquo;est accessible &#8211; au del\u00e0 des 150 premiers mots &#8211; qu&rsquo;aux abonn\u00e9s) fait r\u00e9f\u00e9rence au <a href=\"http:\/\/www.dh.gov.uk\/en\/Publicationsandstatistics\/Publications\/PublicationsPolicyAndGuidance\/DH_072604?IdcService=GET_FILE&amp;dID=134031&amp;Rendition=Web\">Commissionning framework for health and well-being<\/a> qui met de l&rsquo;avant la concertation des autorit\u00e9s locales (principalement municipalit\u00e9s et r\u00e9seau de sant\u00e9) autour des enjeux de sant\u00e9 et bien-\u00eatre. Une concertation bien concr\u00e8te, ax\u00e9e sur des solutions, sur le financement de fa\u00e7ons de faire.<\/p>\n<p>Une approche globale intersectorielle qui commence \u00e0 \u00eatre reconnue dans le domaine de la sant\u00e9 publique, mais qui devrait \u00eatre reprise m\u00eame lorsqu&rsquo;on \u00e9value les interventions plus sp\u00e9cifiques : l&rsquo;utilisation de telle m\u00e9dication (ou th\u00e9rapie) pour traiter telle affection est-elle plus ou moins co\u00fbteuse que telle autre ? Une solution peut sembler efficace si l&rsquo;on ne tient compte que des co\u00fbts imm\u00e9diats imput\u00e9s au r\u00e9seau de la sant\u00e9. Mais si on tient compte des co\u00fbts \u00e0 venir, ou des cons\u00e9quences sur les autres \u00ab\u00a0syst\u00e8mes\u00a0\u00bb (retour au travail ou ch\u00f4mage \u00e0 long terme; soutien \u00e0 la famille ou d\u00e9crochage scolaire&#8230;) certaines interventions apparaissant plus on\u00e9reuses dans l&rsquo;imm\u00e9diat peuvent se r\u00e9v\u00e9ler \u00e9conomiques d&rsquo;un point de vue global.<\/p>\n<blockquote><p>Technology appraisals normally consider only costs falling on the NHS and personal social services budgets in the primary analysis (1). Public health appraisals, however\u2014once the responsibility of the Health Development Agency, which operated under different statutes on public health\u2014can also consider effects on other government budgets. (2) Therefore, an evaluation of a public health intervention to reduce substance abuse would consider the potential advantage gained from a reduction in criminal justice costs, but an evaluation of a drug to treat heroin addiction would not. (BMJ, <a href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/337\/sep29_1\/a1204\">Economic evaluation of health interventions<\/a>)<\/p><\/blockquote>\n<p>(1)  Guide to the methods of technology appraisal. 2008. <a href=\"http:\/\/www.nice.org.uk\/niceMedia\/pdf\/TAP_Methods.pdf\">www.nice.org.uk\/niceMedia\/pdf\/TAP_Methods.pdf<\/a>.<br \/>\n(2) Methods for development of NICE public health guidance. 2006. <a href=\"http:\/\/www.nice.org.uk\/nicemedia\/pdf\/CPHEMethodsManual.pdf\">www.nice.org.uk\/nicemedia\/pdf\/CPHEMethodsManual.pdf<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>L&rsquo;\u00e9valuation des co\u00fbts associ\u00e9s \u00e0 la sant\u00e9 doit d\u00e9passer les seuls frais de l&rsquo;intervention imm\u00e9diate, les seuls frais du r\u00e9seau de la sant\u00e9 et inclure les retomb\u00e9es sur les autres \u00ab\u00a0syst\u00e8mes\u00a0\u00bb : ch\u00f4mage; criminalit\u00e9; \u00e9ducation&#8230; Une question soulev\u00e9e dans le British Medical Journal cette semaine. L&rsquo;article de Drummond et al. (cet article n&rsquo;\u00e9tant pas un &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/gillesenvrac.ca\/carnet\/2008\/10\/evaluations-dimpact-et-de-cout\/\" class=\"more-link\">Continuer la lecture<span class=\"screen-reader-text\"> de &laquo;&nbsp;\u00e9valuations d&#039;impact et de co\u00fbt&nbsp;&raquo;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"atmosphere_disabled":false,"atmosphere_custom_text":"","_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[],"tags":[50,151],"class_list":["post-1045","post","type-post","status-publish","format-standard","hentry","tag-economie","tag-sante-publique"],"jetpack_featured_media_url":"","jetpack-related-posts":[{"id":3797,"url":"https:\/\/gillesenvrac.ca\/carnet\/2011\/06\/reseau-local\/","url_meta":{"origin":1045,"position":0},"title":"r\u00e9seau local de services et responsabilit\u00e9 populationnelle","author":"Gilles Beauchamp","date":"7 juin 2011","format":false,"excerpt":"[L]e CSSS devra constituer et animer un r\u00e9seau local de services (RLS) travaillant d\u2019une fa\u00e7on de plus en plus int\u00e9gr\u00e9e \u00e0 l\u2019am\u00e9lioration de l\u2019\u00e9tat de sant\u00e9 et de bien-\u00eatre de la population ainsi qu\u2019\u00e0 la prise en charge des usagers, notamment des personnes vuln\u00e9rables. (...) le CSSS a la responsabilit\u00e9\u2026","rel":"","context":"Dans \"r\u00e9seau sant\u00e9\"","block_context":{"text":"r\u00e9seau sant\u00e9","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/reseau-sante\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":3147,"url":"https:\/\/gillesenvrac.ca\/carnet\/2010\/02\/strategie-de-dc\/","url_meta":{"origin":1045,"position":1},"title":"strat\u00e9gie de DC pour les CSSS\/DSP","author":"Gilles Beauchamp","date":"22 f\u00e9vrier 2010","format":false,"excerpt":"Un an apr\u00e8s avoir produit un premier document de consultation intitul\u00e9 Cadre de r\u00e9f\u00e9rence pour soutenir l\u2019int\u00e9gration du D\u00e9veloppement des Communaut\u00e9s, qui fut notamment discut\u00e9 lors d'une (exceptionnelle) rencontre entre la Direction de la sant\u00e9 publique de Montr\u00e9al et les organisateurs communautaires des CSSS de la r\u00e9gion, (dont nous avions\u2026","rel":"","context":"Dans \"communaut\u00e9 de pratique\"","block_context":{"text":"communaut\u00e9 de pratique","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/communaute-de-pratique\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":3011,"url":"https:\/\/gillesenvrac.ca\/carnet\/2009\/12\/moins-de-nostalgie\/","url_meta":{"origin":1045,"position":2},"title":"moins de nostalgie et plus de faits, SVP","author":"Gilles Beauchamp","date":"18 d\u00e9cembre 2009","format":false,"excerpt":"Il y a quelques mois, je rencontrais un ex-directeur g\u00e9n\u00e9ral de CLSC (il l\u2019avait \u00e9t\u00e9 dans l\u2019Outaouais et \u00e0 Montr\u00e9al) et sa r\u00e9action imm\u00e9diate sur les CLSC d\u2019aujourd\u2019hui a \u00e9t\u00e9 de dire : \u00abIl faut retourner au travail dans la communaut\u00e9. Je suis atterr\u00e9 de voir comment on a perdu\u2026","rel":"","context":"Dans \"organisation communautaire\"","block_context":{"text":"organisation communautaire","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/organisation-communautaire\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":3167,"url":"https:\/\/gillesenvrac.ca\/carnet\/2010\/03\/etat-de-sante\/","url_meta":{"origin":1045,"position":3},"title":"\u00e9tat de sant\u00e9 ? ou de sant\u00e9 publique ?","author":"Gilles Beauchamp","date":"21 mars 2010","format":false,"excerpt":"Si nous devions, un jour, mettre en place un syst\u00e8me de mesure de l'\u00e9tat de sant\u00e9 des populations locales, par le biais de sondages et autres sources de donn\u00e9es, ce syst\u00e8me devrait non seulement mesurer les \u00e9l\u00e9ments comportementaux et sociologiques habituellement utilis\u00e9s pour d\u00e9crire les facteurs de risques associ\u00e9s aux\u2026","rel":"","context":"Dans \"r\u00e9seau sant\u00e9\"","block_context":{"text":"r\u00e9seau sant\u00e9","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/reseau-sante\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":4403,"url":"https:\/\/gillesenvrac.ca\/carnet\/2013\/02\/pratiques-medicales\/","url_meta":{"origin":1045,"position":4},"title":"pratiques m\u00e9dicales","author":"Gilles Beauchamp","date":"2 f\u00e9vrier 2013","format":false,"excerpt":"La derni\u00e8re version de la Base des donn\u00e9es nationale sur les m\u00e9decins (ann\u00e9e 2010-2011) est disponible sur le site de l'Institut canadien d'information sur la sant\u00e9. Un fichier Zip, contenant deux fichiers Excel sur les paiements et l'utilisation des services m\u00e9dicaux, par province. On y apprend que la r\u00e9mun\u00e9ration totale\u2026","rel":"","context":"Dans \"syst\u00e8me de sant\u00e9\"","block_context":{"text":"syst\u00e8me de sant\u00e9","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/systeme-de-sante\/"},"img":{"alt_text":"rendez-vous le meme jour","src":"https:\/\/i0.wp.com\/www.gillesenvrac.ca\/carnet\/wp-content\/uploads\/2013\/02\/rendez-vous-le-meme-jour.png?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":3175,"url":"https:\/\/gillesenvrac.ca\/carnet\/2010\/04\/territoire-et-responsabilite\/","url_meta":{"origin":1045,"position":5},"title":"territoire et responsabilit\u00e9","author":"Gilles Beauchamp","date":"5 avril 2010","format":false,"excerpt":"La derni\u00e8re livraison du bulletin Infolettre publi\u00e9 par la chaire GETOS pousse une r\u00e9flexion int\u00e9ressante sur la question du territoire et de la responsabilit\u00e9 populationnelle des CSSS. Un autre article du m\u00eame bulletin pr\u00e9sente l\u2019Initiative sur le partage des connaissances et le d\u00e9veloppement des comp\u00e9tences (IPCDC) et son offre de\u2026","rel":"","context":"Dans \"sant\u00e9\"","block_context":{"text":"sant\u00e9","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/sante\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/posts\/1045","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/comments?post=1045"}],"version-history":[{"count":0,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/posts\/1045\/revisions"}],"wp:attachment":[{"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/media?parent=1045"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/categories?post=1045"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/tags?post=1045"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}