公共场所的目标响应者对除的成本效益
G Nichol1, T Valenzuela, D Roe
1F699 Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa Hospital, 1053 Carling Ave, Ottawa, Ontario K1Y 4E9, Canada.
Circulation
|August 6, 2003
概括
在高发病率环境中,训练有素的外层应急人员的快速除可以在医院外心脏骤停时具有成本效益. 与标准的紧急医疗服务 (EMS) 相比,这种方法可能具有很好的价值.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 紧急医疗 紧急医疗
背景情况:
- 医院外心脏骤停 (OHCA) 是一个重要的公共卫生问题,死亡率高.
- 虽然受过训练的非传统响应者的除显示出改善生存的希望,但其成本效益仍然不确定.
- 这项研究调查了公共场所非传统响应者快速除的经济价值.
研究的目的:
- 与标准紧急医疗服务 (EMS) 相比,估计针对非传统响应者的除的增量成本效益.
- 评估公共可访问除方案在心脏骤停频繁的环境中的经济可行性.
主要方法:
- 使用马尔科夫模型,将标准的EMS与有针对性的非传统响应程序进行比较.
- 数据来源于已发表的文献和公共数据库,采用美国社会视角.
- 为了确保结果的稳定性,进行了蒙特卡洛模拟和灵敏度分析,成本和效应的折扣为3%.
主要成果:
- 标准EMS产生的质量调整寿命年 (QALYs) 中位数为0.47,每次逮捕的成本为14,100美元.
- 在场中针对的非传统响应者,每增加QALY.Y增加56,700美元的增量成本.
- 结果对除时间,停止发生率和设备部署敏感.
结论:
- 非传统响应者的快速除可能在心脏骤停频繁和响应时间短的地点具有成本效益.
- 心脏骤停的发生率是确定公共通道除计划最佳地点的关键因素.
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