在加拿大萨斯喀彻温省的一项综合慢性病管理计划的真实世界成本后果分析
John Paul Kuwornu1, Fernando Maldonado2, Gary Groot3
1Research Department, Saskatchewan Health Authority, Regina, SK, Canada.
Health services insights
|January 15, 2024
概括
在萨斯喀彻温省,慢性阻塞性肺病 (COPD) 的新临床途径显示,与历史对照相比,恶化较少. 虽然成本与历史控制相似,但结果略有改善,但成本略高于当代控制.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 肺部病理学 肺部病理学
- 卫生经济学 卫生经济学
背景情况:
- 慢性阻塞性肺病 (COPD) 管理需要综合的方法.
- 临床途径旨在规范护理并改善患者的治疗结果.
- 这种途径的实际成本效益对于医疗保健政策至关重要.
研究的目的:
- 为了比较COPD临床途径计划的实际成本和恶化结果.
- 评估综合疾病管理计划与对照组的有效性.
主要方法:
- 倾向性得分匹配被用来创建可比的成年COPD患者组.
- 研究包括一个临床途径组 (N=759) 和两个对照组 (历史N=759,同时代N=759).
- 使用行政卫生数据,在一年内追踪了患者一级的医疗保健成本和急性COPD恶化.
主要成果:
- 慢性肺炎途径患者的中度和重度恶化风险与历史对照相比显著降低 (HR 0.57和0.43).
- 途径患者的恶化发作比历史 (平均差异 -0.30) 和同时对照 (平均差异 -0.12) 都少.
- 年度医疗保健费用与历史控制相比,但略高于当代控制.
结论:
- 与具有相似成本的历史对照相比,COPD临床途径显示出更好的恶化结果.
- 与当代控制相比,该途径提供了稍微更好的结果,成本略高.
- 综合疾病管理计划,如临床途径,可以有效地管理COPD在现实世界中设置.
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