埃塞俄比亚使用以患者为中心的方法治疗多抗药结核病的治疗成本支持:基于模型的方法
Laura Rosu1, Lucy Morgan2, Ewan M Tomeny3
1Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L35QA, UK. laura.rosu@lstmed.ac.uk.
Infectious diseases of poverty
|July 7, 2023
概括
以患者为中心和混合多耐药结核病 (MDR-TB) 治疗策略比标准护理更具成本效益. 这些方法减少了卫生系统和患者的费用,为MDR-TB管理提供了可行的替代方案.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 传染病管理 传染病管理
背景情况:
- 治疗多药耐药结核病 (MDR-TB) 的高成本仍然存在,即使治疗时间缩短.
- 患者不遵守MDR-TB治疗有助于增加传播和抗菌素耐药性.
- 重组医疗服务以使其更加以患者为中心,可能会降低成本,提高患者的信任和满意度.
研究的目的:
- 与埃塞俄比亚的标准护理相比,研究以患者为中心和混合方法提供MDR-TB护理的成本变化.
- 评估不同抗药性结核病治疗模式的经济影响.
主要方法:
- 利用STREAM试验 (2017-2020) 的已公布数据来填充一个离散事件模拟 (DES) 模型.
- 为三个治疗交付策略建模了患者临床途径的关键特征.
- 将患者成本数据应用于1000个模拟患者途径,计算9个月的MDR-TB治疗费用在2021美元.
主要成果:
- 以患者为中心和混合策略的成本低于标准护理.
- 医疗系统的节省: 219 美元 (以患者为中心) 和 276 美元 (混合).
- 患者储蓄 (没有监护人):389美元 (以患者为中心) 和152美元 (混合).
结论:
- 患者为中心和混合MDR-TB治疗策略比标准护理更具成本效益.
- 有证据支持在常规MDR-TB护理中实施这些策略.
- 结果可以为国家一级的决策和未来的MDR-TB交付实施试验提供信息.
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