在埃斯瓦提尼 (Eswatini) 的门诊诊所和家庭多药耐药结核病管理模式的成本后果分析
Ernest Peresu1, Diana De Graeve2, J Christo Heunis3
1Centre for Development Support, Faculty of Economic and Management Sciences, University of the Free State, Bloemfontein, South Africa.
PloS one
|April 2, 2024
概括
基于家庭的多抗药结核病 (MDR-TB) 护理模式,利用直接观察治疗 (DOT) 和注射的任务转移,被证明比基于诊所的护理更具成本效益. 这种方法为埃斯瓦提尼的患者和护理人员带来了显著的健康和经济效益.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 传染病管理 传染病管理
背景情况:
- 多药耐药结核病 (MDR-TB) 构成了全球重大卫生挑战,需要创新的护理模式.
- 将医疗保健职责的任务转移给非专业的卫生工作者可能会在资源有限的环境中提高获取和效率.
研究的目的:
- 为了比较基于家庭的MDR-TB护理模式的成本后果与基于临床的常规策略在埃斯瓦提尼.
- 评估任务转移直接观察疗法 (DOT) 和注射给卫生工作者的经济和健康益处.
主要方法:
- 进行了成本后果分析,比较了埃斯瓦提尼的家庭和诊所MDR-TB护理模式.
- 关于卫生系统,患者和护理人员成本的数据是在2014年使用文档数据和采访收集的.
- 每位成功治疗的患者的成本是主要的结果指标.
主要成果:
- 基于家庭的模型实现了较高的治疗成功率 (82.1%) 与基于诊所的模型 (67.8%) 相比.
- 每位接受治疗的患者的医疗系统成本是可比的,但在家庭模型中,患者和护理人员的成本要低得多 (275美元与670美元).
- 在家庭模型 (24,157美元) 中,每名成功治疗的患者的成本明显低于在诊所模型 (31,106美元) 中.
结论:
- 基于家庭的MDR-TB护理策略是一种资源高效的方法,提供了实质性的健康和经济优势,特别是对于患者及其家人.
- 该模型为在资源有限的环境中扩展和优化MDR-TB控制提供了一个可行的替代方案.
- 需要进行进一步的研究,以确定门诊家庭MDR-TB护理的最佳治疗支持组件.
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