大動脈瘤経路への包括的老年医学的評価強化型共有意思決定の導入の費用便益分析
David Buxton1,2, Andy Healey3, Bijan Modarai4,5
1Department of General Medicine, Alfred Health, Melbourne, Victoria, Australia.
Age and ageing
|December 19, 2025
まとめ
大動脈瘤修復経路への包括的老年医学的評価(CGA)と共有意思決定(SDM)の導入は、コストを削減します。このアプローチは患者選択を改善し、大幅な部門の節約とより良い結果につながります。
科学分野:
- 血管外科
- 老年医学
- 医療経済学
背景:
- 大動脈瘤修復は、虚弱な患者に対してますます検討されています。
- 手術に適した候補者を特定することは困難です。
- 包括的な老年医学的評価(CGA)と共有意思決定(SDM)は、患者選択と転帰を改善することができます。
研究 の 目的:
- 標準的な術前経路への普遍的なCGA強化SDMの導入の限界費用影響をモデル化すること。
- 大動脈瘤修復における患者選択の改善の費用対効果を評価すること。
主な方法:
- 純費用を比較するために、決定ベースのモデルが開発されました。
- ローカルデータとナショナルデータを使用した2つのシナリオ。
- 感度分析と損益分岐点分析が実施されました。
主要な成果:
- CGAの費用は、手術管理の非増加による節約によって相殺されました。
- 費用便益は、紹介あたり821〜907ポンドと推定されました。
- 手術管理の2.9%〜3.1%の削減により、介入費用が相殺されました。
結論:
- 大動脈瘤経路におけるルーチンのCGA強化SDMは、部門全体のコストを削減します。
- この統合アプローチは、リソース配分を最適化します。
- CGAとSDMによる患者選択の改善は費用対効果が高いです。
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