报告成本和经济影响在随机试验的低价值护理的退出实施干预措施:一个系统的范围审查审查
Petra Falkenbach1, Aleksi J Raudasoja2, Robin W M Vernooij3,4
1Finnish Coordinating Center for Health Technology Assessment, Oulu University Hospital, University of Oulu, Oulu, Finland. petra.falkenbach@pohde.fi.
退出实施的研究很少报告成本,阻碍了可持续发展的努力. 未来的试验必须包括成本数据,以告知决策,并评估减少低价值护理的真正影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 基于证据的实践.
背景情况:
- 废除低价值护理对于医疗保健的可持续性至关重要.
- 评估退出实施策略的直接成本和经济影响至关重要.
研究的目的:
- 评估报告的直接成本和医疗保健成本变化在随机试验的执行.
- 为了识别成本报告中的差距,在执行研究中.
主要方法:
- 在2021年5月之前对MEDLINE和Scopus数据库进行系统审查.
- 独立和重复的选和数据提取227个符合条件的研究.
- 使用修改后的Cochrane工具评估偏差风险.
主要成果:
- 只有8%的研究报告了直接的退出实施成本,19%报告了成本影响.
- 在报告成本影响的63%研究中,医疗保健成本下降.
- 大多数研究集中在减少药物使用 (74%) 和主要使用教育策略 (64%).
结论:
- 停止实施的试验经常遗漏直接成本和经济影响报告 (分别为92%和81%).
- 这种缺乏成本信息限制了政策制定者对退出实施研究的有用性.
- 需要标准化成本报告才能充分评估退出实施计划的价值和可持续性.
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