对急性缺血性中风患者的直接血管学途径的基于活动的时间驱动性成本计算 (TDABC) 怀疑大血管封闭
Kinpritma Sangha1, Timothy White2, Artem T Boltyenkov3
1Siemens Medical Solutions USA Inc., Malvern, PA, United States.
概括
对于急性缺血性中风 (AIS) 的直接血管造影 (DTA) 途径增加了EVT不合格患者的成本. 仔细的患者选择对于优化DTA途径至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 神经学 神经学
- 干预性放射学 干预性放射学
背景情况:
- 直接血管造影 (DTA) 是急性缺血性中风 (AIS) 内血管治疗 (EVT) 的新途径.
- DTA 改善了 EVT 合格患者的治疗时间和治疗结果.
- DTA途径的机构成本和成本驱动因素尚未得到充分研究.
研究的目的:
- 评估和比较DTA途径与常规CT途径对AIS患者的机构成本,怀疑前部循环中大血管封闭 (LVO).
- 确定与每个途径相关的主要成本驱动因素.
主要方法:
- 利用基于时间驱动的基于活动的成本计算 (TDABC) 模型,从医疗机构的角度比较途径成本.
- 采用流程映射来详细描述每个路径步骤的活动和资源.
- 开发了使用机构患者数据和纽约州工资平均值的成本模型.
主要成果:
- 与传统途径相比,DTA途径对所有AIS患者的总成本增加了82,583.61美元 (9%).
- 对于不符合EVT条件的患者,DTA途径的费用比CT途径高出82,964.37美元 (76%).
- 对于符合EVT条件的患者,CT途径的成本更高,总共为380.76美元 (0.04%) 和每位患者5.60美元 (0.04%).
结论:
- DTA途径导致EVT不合格患者的成本显著增加 (82,964.37美元的额外成本).
- 实施适当的患者选择标准对于减轻与DTA途径相关的成本增加至关重要.
- 优化患者选择可以提高DTA途径对急性缺血性中风治疗的成本效益.
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