上述Rh免疫球蛋白的经济分析,用于怀孕时的出血<12周妊娠期
Sarah Horvath1, Li Wang2, William Calo2
1Department of Obstetrics and Gynecology, H103, Penn State College of Medicine, Hershey Medical Center, Hershey, PA, United States.
Contraception
|June 21, 2024
概括
放弃 RhD 测试和 Rh 免疫球蛋白 (RhIg) 用于早期妊娠出血 (<12 周) 可以为美国医疗保健支付者节省数百万美元. 这种策略可以保存RhIg以后使用,特别是如果敏感化风险低于3%.
科学领域:
- 产科和妇科 产科和妇科
- 卫生经济学 卫生经济学
- 预防医学 预防医学
背景情况:
- 常规的RhD血型检测和Rh免疫球蛋白 (RhIg) 给药是RhD阴性个体在怀孕早期经历出血的标准.
- 怀孕12周以下这种做法的必要性和成本效益需要重新评估,特别是在潜在的成本节约和资源保护的背景下.
研究的目的:
- 进行成本分析,比较当前的护理标准与放弃RhD测试和RhIg在美国怀孕12周以下怀孕期间出血的RhIg注射的策略.
- 根据不同的敏感化风险情景,确定医疗保健支付人的经济影响和潜在节省.
主要方法:
- 开发了一个决策分析模型来比较两个途径:当前的标准和一个建议的途径,省略 RhD 测试和 RhIg 对于 RhD 阴性个体在怀孕12周以下.
- 人口和成本估计来自现有文献.
- 使用不同的Rh敏感化风险 (0%,1.5%,3%) 和随后的怀孕率进行了敏感性分析.
主要成果:
- 放弃RhD测试和RhIg在12周以下的出血事件,可以为美国医疗保健支付人每10万例怀孕节省大约550万美元,假设敏感性风险为0%.
- 在1.5%的敏感化风险和84.3%的后续怀孕率下,每10万例怀孕估计节省280万美元,需要治疗的数量为7,322.
- 目前的标准途径被发现只有3%的敏感率才是最经济的.
结论:
- 成本分析表明,放弃RhD血型查和在怀孕12周以下给予RhIg是经济有利的,当Rh敏感化风险低于3%时.
- 取消这种做法,在这种情况下被认为是低价值的护理,可以为美国纳税人节省大量成本,并允许保存RhIg以在怀孕后期使用.
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