加拿大萨斯喀彻温省慢性阻塞性肺病临床途径的经济评估:基于数据的技术,在患者子组中确定成本效益
John Paul Kuwornu1, Fernando Maldonado2, Gary Groot3
1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
PloS one
|April 1, 2024
概括
萨斯喀彻温省的慢性阻塞性肺病 (COPD) 护理途径整体上并不具有成本效益. 然而,它对年轻的患者和患有并发症的患者显示出好处,表明有针对性的实施可能是有价值的.
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
- 肺部病理学 肺部病理学
背景情况:
- 萨斯喀彻温省已经为常见的健康状况实施了各种护理途径.
- 该省尚未对护理途径进行任何先前的成本效益评估.
- 这项研究解决了评估慢性阻塞性肺病 (COPD) 护理途径计划的实际成本效益的需要.
研究的目的:
- 评估萨斯喀彻温省COPD护理途径计划的实际成本效益.
- 确定COPD护理途径最具成本效益的患者子组.
- 评估护理途径对COPD无恶化日的影响.
主要方法:
- 使用了来自雷吉纳 (干预) 和萨斯卡通 (控制) 的患者级管理健康数据.
- 包括患有COPD的成年人 (35岁以上) (N=759个组),使用倾向分数进行匹配.
- 在1年的随访中,使用患者一级的成本和COPD无恶化日,使用手动和数据驱动的政策学习方法分析了成本效益.
主要成果:
- 对于整个样本来说,COPD护理途径的成本效益并不高,愿意支付1,000-5,000美元的门/避免恶化的一天.
- 手动小组分析显示,在患有并发症的患者和65岁以下的患者中,在2000美元/恶化日避免值时,成本效益.
- 数据驱动的政策学习证实了这些概况,并提出了更细致的人口和疾病特征,以实现最佳途径的适用性.
结论:
- 慢性肺炎护理途径在特定亚组中证明了成本节约和改善健康结果:患有并发症的患者和年轻患者 (≤65岁).
- 对于整个患者样本,没有确定整体的成本效益.
- 针对性地实施COPD护理途径可能更有利于特定的患者人口统计和疾病概况.
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