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治疗败血症休克的多素B血 perfusion 的成本效益:使用日本全国行政数据库的观察性研究

Kenji Fujimori¹, Kunio Tarasawa², Kiyohide Fushimi³

¹Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan. fujimori@med.tohoku.ac.jp.

Journal of anesthesia, analgesia and critical care

|June 29, 2023

概括

聚氨酸B血输液 (PMX) 是治疗败血症的一种具有成本效益的方法,可显著降低死亡率并改善质量调整寿命年数 (QALYs). 这项研究证明了PMX疗法.

科学领域:

临界护理医学临界护理医学
卫生经济学卫生经济学
腎臟病學 (nephrology) 是一種醫學專業.

背景情况:

聚氨酸B血输液 (PMX) 是一种已知的治疗方法,用于清除败血症休克患者的内毒素.
尽管在临床上使用了20多年,但缺乏PMX治疗的详细成本效益分析.

研究的目的:

为了评估Polymyxin B血 perfusion (PMX) 在患有败血症的成年患者的成本效益.
为了比较PMX治疗和非PMX治疗的败血症患者之间的医疗费用和质量调整后寿命 (QALYs).

主要方法:

使用了日本诊断程序组合 (DPC) 数据库 (2018年4月-2021年3月).
包括成人败血症患者,他们的SOFA分数在7到12之间.
员工倾向得分匹配以比较PMX和对照组,计算增量成本效益比率 (ICER).

主要成果:

与对照组 (2895名患者) 相比,PMX组 (965名患者) 的28天和住院死亡率显著降低.
在PMX组中,平均医疗费用更高 (差别为6935欧元).
治疗PMX导致预期寿命长 (1.70年),寿命年增长 (0.86年) 和QALY (0.60年).

结论:

聚氨酸B血 perfusion (PMX) 是一个经济上可接受的治疗败血症.
计算的ICER为11,592欧元/年,低于支付意愿的门,表明有利的成本效益.

关键词:

经济效益性经济效益性 DPC 数据库的数据库是 DPC 的数据库.在PMX中使用PMX.聚氨酸B 血输液聚氨酸B 血输液倾向性得分匹配的匹配方法败血症这是一种败血症.

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