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Ethical health technology assessment in Latin America: lessons from Canada and Argentina
Martin,Carolina; Williams-Jones,Bryn; de Ortúzar,María Graciela;
Acta bioethica , 2011, DOI: 10.4067/S1726-569X2011000200009
Abstract: a wide array of biomedical and genetic technologies is becoming available in both developed and developing nations. this situation is the cause of growing concern for health policy makers who must evaluate the utility of these technologies for their inclusion in public health insurance programs. ideally, policy makers would have the information necessary to rationally allocate scarce resources, prioritise technologies, and ensure fair access to necessary health care services. the reality, however, is that policy makers often do not have such information. in this paper, we argue that the field of health technology assessment (hta), through the integration of ethical analyses (i.e., an "ethical hta"), can enable argentinean and other latin american policy makers to better understand the soco-ethical concerns raised by new biotechnologies.
Ethical health technology assessment in Latin America: lessons from Canada and Argentina Evaluación ética de la tecnología en salud de Latinoamérica: lecciones aprendidas de Canadá y Argentina Avalia o ética da tecnologia em saúde na América Latina: li es aprendidas do Canadá e Argentina
Carolina Martin,Bryn Williams-Jones,María Graciela de Ortúzar
Acta Bioethica , 2011,
Abstract: A wide array of biomedical and genetic technologies is becoming available in both developed and developing nations. This situation is the cause of growing concern for health policy makers who must evaluate the utility of these technologies for their inclusion in public health insurance programs. Ideally, policy makers would have the information necessary to rationally allocate scarce resources, prioritise technologies, and ensure fair access to necessary health care services. The reality, however, is that policy makers often do not have such information. In this paper, we argue that the field of Health Technology Assessment (HTA), through the integration of ethical analyses (i.e., an "ethical HTA"), can enable Argentinean and other Latin American policy makers to better understand the soco-ethical concerns raised by new biotechnologies. Una amplia gama de tecnologías biomédicas y genéticas ya se encuentra disponible tanto en los países desarrollados como en vías de desarrollo. De allí la importancia de evaluar dichas tecnologías para su ulterior inclusión en los programas de salud pública. Idealmente, los responsables de formular políticas dispondrían de la información necesaria para asignar los escasos recursos de manera racional, priorizar tecnologías y asegurar un acceso equitativo a los servicios de salud. Sin embargo, la realidad es que los responsables de formular políticas carecen a menudo de dicha información. En este trabajo argumentamos que la evaluación ética de tecnologías sanitarias permitiría a los decisores políticos argentinos y de otros países latinoamericanos comprender mejor las inquietudes socio-éticas que las nuevas biotecnologías plantean. Foi disponibilizada uma ampla cole o de tecnologias biomédicas e genéticas tanto em países desenvolvidos como nos países em desenvolvimento. Esta situa o é a causa de preocupa o crescente dos formuladores de políticas públicas de saúde sobre como avaliar a utilidade destas tecnologias para a sua inclus o em programas de saúde pública. Idealmente, os formuladores de políticas públicas deveriam ter a informa o necessária para distribuir racionalmente os escassos recursos, priorizar tecnologias e garantir acesso justo aos servi os de cuidado à saúde necessários. A realidade, entretanto, é que os formuladores de políticas públicas em geral n o têm tal informa o. Neste artigo, argumentamos que o campo da avalia o de tecnologia de saúde (ATS), através da integra o de análise ética (ex., uma "ATS ética"), pode capacitar os formuladores de políticas públicas da Argentina e de outros países latino-
Displacements: Is it possible to reduce vehicular congestion?
Juan de Dios Ortúzar
ARQ , 2002,
Abstract:
Desplazamientos: Es posible reducir la congestión?
Juan de Dios Ortúzar
ARQ , 2002,
Abstract:
Igualdad Social, Justicia y Políticas de Salud
de Ortúzar,María Graciela;
Revista Latinoamericana de Bioética , 2011,
Abstract: the aim of the present work is to integrate the results of the empirical studies on the impact of the social inequality in health, with the normative studies that justify different models of justice and public policies of health care. the methodology selected is "reflective equilibrium" the end: to offer not only a contribution to the theoretical ethics, but also, and very specially, to offer an integration of the knowledge of the science, the political philosophy and the applied ethics, for the design of public policies that reduce inequalities in health care.
Igualdad de acceso a la telesanidad en zonas rurales y aisladas: propuesta de un marco ético normativo integral de acceso y distribución
de Ortúzar,María Graciela;
Revista Latinoamericana de Bioética , 2009,
Abstract: according to the world medical association, the use of icts (information and communicational technologies) in health care (telemedicine), "is the practice of medicine, from a distance, in which interventions, diagnostic and treatment decisions and recommendations are based on clinical data, documents and other information transmitted through telecommunication systems". this new practice in the health care system cause new ethical, legal, social and technological implications that effects the current health care model. generally speaking, the problem of confidenciality has been prioritized in the use of medical information. however, one of the most important ethical issues is "equality of opportunity" in the access to icts in health care (prevention, treatment, cure and rehabilitation). for that reason, the aim of the present work is to create an ethical framework in order to evaluate and regulate the impact on the health care access of the telemedicine programmes in isolated and rural areas. secondly, the regulation of the use of icts in health care will be analyzed, considering: professional and social responsibilities, confidentiality in the use of medical information (electronic clinical histories, access to data base), among others. the methodology is reflective equilibrium in theory and practice. the general hypothesis of this work is that a fair, ethical and integral framework is required to evaluate and regulate the use of telemedicine programmes in isolated and rural areas since the impact of the equal access to the communities constitutes the only alternative health care system in those areas.
El problema de modelación de demanda desde una perspectiva desagregada: el caso del transporte
Ortúzar,Juan de Dios; Román,Concepción;
EURE (Santiago) , 2003, DOI: 10.4067/S0250-71612003008800007
Abstract: disaggregate models, based on the study of individual's behavior making their consumption choices, are considered today the rigth tool in the analysis and predition of demand. this discipline has experienced an increasing development in the last decades, both in a methodological and emprirical level. in this article, an actualized overview of the problem of demand modeling from a disaggregate perspective is presented, emphasizing the case of the transport, in wich the mayor part of the applications has been developed. microeconomical basis, the most important aspects related to modeling and the sources of information of this modeles are analyzed. in relation with this sources, a special mention about the modeling with declared preferences and mixed data is made
Cuantificando la Percepción de Inseguridad Ciudadana en Barrios de Escasos Recursos
Sillano,Mauricio; Greene,Margarita; Ortúzar,Juan de Dios;
EURE (Santiago) , 2006, DOI: 10.4067/S0250-71612006000300002
Abstract: urban safety has become a key issue for life in the city. a strategy that may positively affect quality of life is the urban design of public spaces; however, previous efforts have not been based on hard data, hampering a serious evaluation of alternative solutions. this work discusses the methodology and primary results of a study geared to quantify the perception of safety in low income areas, and how this is affected by the spatial arrangement of neighborhoods. we are interested in quantifying the effect of spatial variables regarding the feelings of fear associated with the use of public space, with the objective to evaluate policies to improve security based on hard data rather than unproven speculation. we designed and implemented a stated preference survey to measure the relative perceptions of insecurity experienced by residents traveling through specific neighborhoods in santiago. the relative importance of each variable was determined using flexible discrete choice models. results suggest that the proposed approach could become an efficient technique for the evaluation of urban safety policies
El problema de modelación de demanda desde una perspectiva desagregada: el caso del transporte
Juan de Dios Ortúzar,Concepción Román
EURE (Santiago) , 2003,
Abstract: Los modelos desagregados, basados en el estudio del comportamiento de los individuos a la hora de tomar sus decisiones de consumo, constituyen hoy por hoy la herramienta adecuada en el análisis y predicción de la demanda. Esta disciplina ha experimentado un creciente desarrollo en las últimas décadas, tanto a nivel metodológico como empírico. En este artículo se presenta una panorámica general actualizada del problema de la modelización de la demanda desde una perspectiva desagregada, haciendo especial hincapié en el caso del transporte, donde se han desarrollado la mayor parte de las aplicaciones. Se analizan los fundamentos microeconómicos, los aspectos más relevantes relacionados con la modelización y las fuentes de información de las que se nutren estos modelos. En relación a estas últimas se hace una mención especial a la modelización con datos de preferencias declaradas y datos mixtos Disaggregate models, based on the study of individual's behavior making their consumption choices, are considered today the rigth tool in the analysis and predition of demand. This discipline has experienced an increasing development in the last decades, both in a methodological and emprirical level. In this article, an actualized overview of the problem of demand modeling from a disaggregate perspective is presented, emphasizing the case of the transport, in wich the mayor part of the applications has been developed. Microeconomical basis, the most important aspects related to modeling and the sources of information of this modeles are analyzed. In relation with this sources, a special mention about the modeling with declared preferences and mixed data is made
Cuantificando la Percepción de Inseguridad Ciudadana en Barrios de Escasos Recursos
Mauricio Sillano,Margarita Greene,Juan de Dios Ortúzar
EURE (Santiago) , 2006,
Abstract: La seguridad ciudadana ha pasado a ser un tema clave en la vida de las ciudades. Un enfoque que puede afectar positivamente la calidad de vida de los habitantes urbanos es el dise o del espacio público, pero experiencias anteriores han carecido de datos que permitan evaluar seriamente posibles alternativas de solución. Este trabajo discute la metodología y presenta los principales resultados de un estudio enfocado a cuantificar la percepción de seguridad de habitantes de barrios residenciales de escasos recursos, y cómo ésta es afectada por su configuración espacial. Interesa cuantificar el efecto de variables espaciales sobre la sensación de temor asociada a recorrer el hábitat cotidianamente, con el objetivo de evaluar políticas de mejoramiento de la seguridad ciudadana basadas en información empírica comprobable y no en especulaciones. Se dise ó y aplicó una encuesta de preferencias declaradas para medir las percepciones relativas de inseguridad experimentadas por los residentes al transitar por distintos sectores de Santiago. La importancia relativa de cada variable se estimó utilizando modelos flexibles de elección discreta. Los resultados sugieren que el enfoque propuesto podría constituirse en una eficaz técnica para la evaluación de políticas de seguridad urbana Urban safety has become a key issue for life in the city. A strategy that may positively affect quality of life is the urban design of public spaces; however, previous efforts have not been based on hard data, hampering a serious evaluation of alternative solutions. This work discusses the methodology and primary results of a study geared to quantify the perception of safety in low income areas, and how this is affected by the spatial arrangement of neighborhoods. We are interested in quantifying the effect of spatial variables regarding the feelings of fear associated with the use of public space, with the objective to evaluate policies to improve security based on hard data rather than unproven speculation. We designed and implemented a stated preference survey to measure the relative perceptions of insecurity experienced by residents traveling through specific neighborhoods in Santiago. The relative importance of each variable was determined using flexible discrete choice models. Results suggest that the proposed approach could become an efficient technique for the evaluation of urban safety policies
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