经过质量调整的生命年是否歧视老年人? 对已发表的成本效益分析进行实证分析
Feng Xie1, Ting Zhou2, Brittany Humphries3
1Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada; Centre for Health Economics and Policy Analysis, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
这项研究没有发现质量调整后寿命年 (QALY) 在成本效益分析 (CEA) 中歧视老年人. 对于65岁及以上的患者发表的CEA显示了与年轻患者相似的结果.
科学领域:
- 卫生经济学 卫生经济学
- 医疗决策的制定 医疗决策的制定
- 老年医学 老年医学
背景情况:
- 批评人士认为,质量调整寿命年 (QALYs) 可能会歧视老年人群.
- 在成本效益分析 (CEA) 中支持或反驳这一说法的经验证据有限.
研究的目的:
- 将65岁及以上患者的已发表CEA与65岁以下患者的CEA进行比较.
- 在基于QALY的CEA中调查潜在的基于年龄的歧视.
主要方法:
- 来自塔夫斯成本效益分析注册表 (1976-2021) 的CEA的系统审查.
- 根据患者年龄 (≥65 vs <65岁) 划分CEA的分类.
- 增加性成本效益比率 (ICER) 分布的比较和成本效益结论的后勤回归分析.
主要成果:
- 分析包括4445个CEA (3784个65岁以下,661个65岁以上).
- 在年龄组之间的ICER分布中没有发现系统差异.
- 后勤回归表明结论成本效益的可能性相似,调整后的赔率比率接近1.
结论:
- 使用QALY发布的CEA没有基于患者年龄的系统差异.
- 这些发现表明,在经济评估中,在不同年龄组中,QALYs被一致应用.
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