双与单板固定移动中轴关节骨折:一个成本效益分析分析
Shaquille J-C Charles1, Praveen Kumar2, Rajiv P Reddy3
1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
The Journal of bone and joint surgery. American volume
|November 15, 2023
概括
对于移位的中轴关节骨折,双 (DP) 比单 (SP) 更具成本效益,降低了重复手术率并改善了患者的生活质量. 这种方法提供了更好的长期价值,尽管初始硬件成本较高.
科学领域:
- 整形外科手术 整形外科手术
- 卫生经济学 卫生经济学
- 决策分析 决策分析
背景情况:
- 双 (DP) 在中轴关节骨骨折中显示出较低的重复操作率,而不是单 (SP).
- 较高的DP初始成本可能会被减少的二次手术所抵消,这表明潜在的成本效益.
- 以前的研究表明,DP可能是一个更具成本效益的治疗选择,用于移位的中轴关节骨骨折.
研究的目的:
- 评估双 (DP) 与单 (SP) 相比的成本效益.
- 为了评估DP与SP对于操作上指示的移位中轴关节骨骨折.
- 确定DP是否在管理这些断裂方面提供更好的长期价值.
主要方法:
- 开发了一个决策树模型来模拟术后并发症和重新手术.
- 基于文献的并发症风险估计 (例如,非结合,感染) 对于两种涂技术都被汇总在一起.
- 从医疗保健支付人的角度进行了两年时间的分析,衡量了成本和质量调整后寿命年 (QALY).
主要成果:
- 据DP预测,复工率为6%,而SP则为14%.
- DP使QALY增加了0.005,每名患者的成本增加了71美元,每次QALY的ICER为13,242美元.
- 敏感性分析表明,DP的成本效益受到指数手术成本和SP/DP的并发症风险的影响.
结论:
- 双 (DP) 是与单 (SP) 相比,用于移位中轴关节骨骨折的操作管理的成本效益高的策略.
- 较高的初始硬件成本由较低的重新操作率和改善患者生活质量来证明是合理的.
- 这些发现支持DP作为一种首选的治疗选择,以实现更好的健康效用和长期价值.
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