在携带多药耐药微生物的患者中,与可重复使用的十二指镜相比,一次性十二指镜:平衡成本分析
Judith A Kwakman1,2, Marten J Poley3,4, Margreet C Vos2
1Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
Endoscopy international open
|June 12, 2023
概括
对于携带多药耐药微生物 (MDROs) 的患者,单次使用的十二指镜是一种具有成本效益的替代方案. 有针对性的方法,而不是完全切换,使一次性使用模式在经济上可行.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 卫生经济学 卫生经济学
背景情况:
- 可重复使用的十二指望镜存在多药耐药微生物 (MDRO) 传播的风险.
- 经济和环境方面的担忧阻碍了一次性十二指镜的采用.
- 在特定的患者群体中研究一次性十二指镜的成本效益至关重要.
研究的目的:
- 评估单次使用十二指镜的折旧成本,用于接受ERCP的携带MDROs的患者.
- 为了比较两个查方法:微生物培养和快速GeneXpert分析.
- 评估荷兰和美国医疗保健机构的经济可行性.
主要方法:
- 对一次性十二指镜的平衡成本分析.
- 两个场景:标准培养基查与快速GeneXpert查.
- 考虑了与内镜相关的直接成本;使用了来自荷兰和美国医疗保健系统的数据.
主要成果:
- 在荷兰,一次性十二指镜的平衡价格在140欧元到250欧元之间.
- 美国的平衡成本差异很大 (第一场景为78.21美元,第二场景为2,747.54美元;第二场景为248.89美元,第二场景为2,209.23美元).
- 成本效益取决于感染成本,ERCP数量和感染风险.
结论:
- 针对MDRO载体的单次使用十二指镜的有针对性的使用是经济可行的.
- 这种交叉策略为完全采用一次性十二指镜提供了替代方案.
- 与美国相比,荷兰的一次性十二指镜需要更低的价格,因为成本相似.
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