超导管大动脉植入术的财务负担
Paola D'Errigo1, Andrea Marcellusi2, Fausto Biancari3
1National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy.
The American journal of cardiology
|July 21, 2023
概括
新的透管大动脉植入器 (TAVI) 设备和经验的增加,通过降低再入院和死亡率,显著降低了成本. 这使得TAVI疗法在一年内节省了大量的资金.
科学领域:
- 心血管医学 心血管医学
- 卫生经济学 卫生经济学
- 医疗技术评估 医疗技术评估
背景情况:
- 跨导管大动脉植入 (TAVI) 越来越多地用于大动脉狭窄.
- 资源利用和成本效益是TAVI治疗的关键考虑因素.
- 将早期的TAVI实践与较新的方法进行比较对于理解财务影响至关重要.
研究的目的:
- 估计TAVI治疗的财务负担在较早时期和较晚时期的变化,使用较新的设备和增加中心经验.
- 量化与TAVI程序进步相关的成本节约.
主要方法:
- 开发了一个概率马尔科夫模型来比较1年的成本.
- 使用了来自OBSERVANT和OBSERVANT II研究的数据,包括853对患者的倾向性得分匹配.
- 关键结果包括再住院率,再干预率和1年死亡率.
主要成果:
- 新的TAVI期间显示,重新住院的数量显著减少 (-30.5%的重新干预,-25.2%的重大事件,-30.8%的轻微事件) 和1年死亡率下降20%.
- 观察到显著的成本节约: - 410万欧元的直接成本和 - 1970万欧元包括设备成本.
- 再住院费用占总成本降低的79%,不包括设备费用.
结论:
- 采用新一代TAVI设备和增强的中心经验导致与早期TAVI时期相比大幅节省1年的成本.
- 重新住院率的降低是这些成本节约的主要驱动因素.
- 这些发现支持TAVI进步和程序学习曲线的经济效益.
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