在通用医疗保健系统中实施预孕扩展载体查:基于模型的成本效益分析
Andrea Busnelli1, Oriana Ciani2, Silvia Caroselli3
1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
概括
扩展载体查 (ECS) 面板对意大利夫妇来说比不进行查更具成本效益. 这项研究评估了三个ECS小组,发现它们在经济上有利于全民医疗保健系统.
科学领域:
- 医学遗传学 医学遗传学
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 关于成本效益 (CE) 的有限证据阻碍了全球范围内的扩大载体查 (ECS) 的采用,包括在意大利.
- 意大利目前在计划怀孕时使用无查模型进行遗传风险评估.
研究的目的:
- 根据意大利目前的无选方法,估计三个ECS面板的CE.
- 在意大利的全民医疗保健系统内实施ECS的政策决策中提供信息.
主要方法:
- 从意大利普遍医疗保健系统的角度开发了一个CE模型.
- 该模型模拟了三个ECS面板:ACMG一级,集中选和ACMG三级.
- 假设包括100%的敏感性,高风险夫妇的77%干预率,以及追求干预的不愿风险夫妇没有受孕风险.
主要成果:
- 所有三个ECS小组都显示了与没有查相比的积极CE.
- 对ACMG1S的增量CE比率为-14,875欧元±1,208/LYG,针对性查为-106,863欧元±2,379/LYG,对ACMG3S的增量CE比率为-47,277欧元±1,430/LYG.
- 发现ACMG1S和聚焦查被ACMG3S所主导,显示出优越的价值.
结论:
- 所有被评估的ECS小组都提出了比意大利目前的无选模式更具成本效益的策略.
- 这些发现支持将ECS整合到意大利的全民医疗保健系统中,以提高经济效率.
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