在心脏骤停中运送的患者中终止复苏规则的成本效益比较
Kamran A Khan1, Stavros Petrou2, Michael Smyth1
1Warwick Medical School, University of Warwick, United Kingdom.
Resuscitation
|June 15, 2024
概括
韩国心脏骤停研究联盟2 (KOC2) 的终止复苏 (TOR) 规则是医院外心脏骤停患者最具成本效益的规则. 这一发现支持在英国实施TOR规则方面做出明智的医疗保健决策.
科学领域:
- 紧急医疗 紧急医疗
- 卫生经济学 卫生经济学
- 临床决策 - 临床决策
背景情况:
- 终止复苏 (TOR) 规则对于心脏骤停患者的管理至关重要.
- 评估不同TOR规则的成本效益对于优化医疗保健资源分配至关重要.
- 目前的做法和各种国际TOR指南存在,需要进行比较经济分析.
研究的目的:
- 为了比较各种终止复苏 (TOR) 规则的成本效益,患者经历了医院外心脏骤停 (OHCA).
- 从国家卫生服务 (NHS) 和个人社会服务 (PSS) 的角度来看,确定最经济可行的TOR规则.
- 为英国的医疗保健决策提供有关TOR规则实施的信息.
主要方法:
- 一项系统性审查确定了33个TOR规则.
- 经济分析评估了29个TOR规则以及使用OHCAO注册,试验数据和文献数据的现行实践.
- 增量成本效益比率 (ICER) 计算基于 NHS 和 PSS 的折扣成本和经质量调整的寿命年 (QALY).
主要成果:
- 韩国心脏骤停研究联盟2 (KOC2) TOR规则显示,每QALY的成本效益为17,548英.
- 欧洲复苏委员会 (ERC) 的TOR规则的ICER为8,111英.
- 发现KOC 2 TOR规则在英国每QALY建立的20,000-30,000英门内具有成本效益.
结论:
- 在英国确立的成本效益门下,KOC 2 TOR规则是OHCA患者最具成本效益的选择.
- 建议对TOR规则的经济影响进行进一步研究.
- 这些发现可以指导关于在临床实践中实施有效的TOR规则的建设性讨论.
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