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提高AED的成本效益,使用算法优化位置

Robin Buter¹, Hans van Schuppen², Remy Stieglis²

¹Center for Healthcare Operations Improvement and Research, University of Twente, Drienerlolaan 5, 7500 AE Enschede, The Netherlands; Industrial Engineering and Business Information Systems, University of Twente, Drienerlolaan 5, 7500 AE Enschede, The Netherlands.

|July 3, 2024

概括

将战略性放置的自动外部除器 (AED) 添加到志愿者响应系统 (VRS) 中,以提高医院外心脏骤停 (OHCA) 存活率. 增加AED至1120提供在80,000欧元/QALY值内显著的健康收益.

科学领域:

公共卫生公共卫生
卫生经济学卫生经济学
紧急医疗紧急医疗

背景情况:

志愿者响应系统 (VRS) 旨在通过减少除时间来改善医院外心脏骤停 (OHCA) 的存活率.
自动化外部除器 (AED) 对于OHCA的生存至关重要,但由于位置不理想,它们往往未得到充分利用.
在VRS框架内,对AED的战略布置是最大限度地提高其有效性的关键.

研究的目的:

在一个VRS中进行增加战略位置的AED数量的成本效益分析.
确定最佳的额外AED数量,以最大限度地提高质量调整寿命年 (QALYs).

主要方法:

模拟的联合响应场景,涉及志愿者,警察,消防员和OHCAs的紧急医疗服务.
适用于荷兰阿姆斯特丹的一个案例研究,比较了0到1480个额外的AED的策略.
从社会角度计算增量成本效益比率 (ICER),并使用后勤回归来估计基于AED连接数据的生存率和神经结果.

主要成果:

增加多达1120个战略位置的AED被发现是具有成本效益的,ICER为75,669欧元/QALY,支付意愿的门为80,000欧元/QALY.
这一策略导致每个OHCA获得0.111个QALY,增加了3792.2欧元的成本.
随着AED总数的增加,观察到每增加AED的健康益处下降.

结论:

确定了成本效益高的战略,以优化AED在VRS中的放置.
这些发现支持阿姆斯特丹的AED部署大幅增加,以加强OHCA的响应.
战略性AED安置是一种可行的方法,可以改善心脏紧急情况的公共卫生结果.

关键词:

自动化的外部除器.对成本效益的分析.优化优化优化医院外的心脏病发作停止.公共卫生公共卫生志愿者响应系统的系统.

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