由于机构能力和财政资源的限制,全民健康覆盖(UHC)之路涉及艰难的政策选择。为了协助这些选择,学者和政策制定者在评估卫生筹资政策实质性公平性的标准方面做了大量工作:它们对权利分配的影响,职责,在通往UHC的道路上的利益和负担。然而,对卫生筹资决策的程序公平性关注较少。合理性问责框架(A4R),广泛应用于评估程序公正性,主要用于采购决策的优先级设置,收入调动和汇集受到的关注有限。此外,A4R框架的四个标准(宣传,相关性,修订和上诉,和执法)受到质疑。此外,政治理论和公共行政(包括协商民主)研究,公共财政,环境管理,心理学,卫生筹资研究了程序公平性的关键特征,但是,这些见解尚未综合为卫生筹资中公平决策过程的综合标准。还缺乏对这些标准如何应用于与卫生筹资有关的决策情况和其他领域的系统研究。本文通过范围审查来解决这些差距。它认为,可以将许多学科的文献综合为具有共同哲学基础的10个核心标准。这些超越了A4R,涵盖了平等,公正,随着时间的推移一致性,给出理由,透明度,信息的准确性,参与,包容性,可修订性和强制执行性。这些标准可用于评估和指导不同国家收入水平和卫生筹资安排的UHC筹资决策过程。审查还提供了如何将这些标准应用于卫生筹资和其他部门决策的示例。
Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework\'s four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors.