对晚期癌症患者早期息护理干预的经济评估
Maud Maessen1,2, Monica C Fliedner2, Brigitta Gahl3
1Institute of Social and Preventive Medicine, University of Bern, Switzerland.
Swiss medical weekly
|April 5, 2024
概括
早期息治疗整合并没有显著改变晚期癌症患者在生命的最后一个月的医疗保健利用率或成本. 虽然受到患者的赞赏,但单一结构化的干预措施却受到患者的赞赏.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 卫生经济学 卫生经济学
背景情况:
- 在瘤学中早期的息护理整合改善了患者的生活质量和症状管理.
- 潜在的成本降低是早期息护理的一个主要提议的好处.
- 由于干预的可变性和缺乏剂量反应数据,早期息护理的成本效益仍然存在不确定性.
研究的目的:
- 评估早期息护理干预是否能减少生命最后一个月的医疗保健利用率和成本.
- 为了比较通常的瘤治疗和瑞士医院环境中的综合早期息治疗之间的成本和利用率.
主要方法:
- 与多中心试验一起进行了成本后果分析.
- 关于成本的数据是从行政医疗保险索赔中提取的.
- 通过家庭护理人员调查收集了医疗保健利用数据.
- 该干预涉及一个单一的,结构化的多专业对话 (SENS) 在晚期癌症的诊断后16周内.
主要成果:
- 在经济评估中包括了58名晚期癌症患者.
- 干预组 (CHF 7892) 和对照组 (CHF 8492) 在生命最后一个月的医疗费用中位数相似.
- 早期息护理干预的平均成本为每名患者380瑞士法郎.
- 没有观察到医疗保健利用率或总体成本的显著差异 (p = 0.98).
结论:
- 单一结构化的早期息护理干预 (SENS) 在生命的最后一个月没有显著影响医疗保健利用率或成本.
- 缺乏重大发现的潜在原因包括干预强度不足,时间短或研究人群小.
- 患者报告了干预措施的积极经验,该干预措施易于实施,治疗成本低.
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