非手术治疗的成本效益与1年的儿科无并发尾炎前期腹腔镜尾切除术相比
Lindsay A Gil1,2, Lindsey Asti1,3, Huey-Fen Chen1
1From the Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH (Gil, Asti, Chen, Pattisapu).
Journal of the American College of Surgeons
|November 19, 2024
概括
非手术治疗 (NOM) 是治疗儿科无并发性尾炎的成本效益高的策略,比一年的手术更便宜,更有效. 这种方法在管理这种常见的儿童状况方面具有显著的价值.
科学领域:
- 儿科手术 儿科手术
- 卫生经济学 卫生经济学
- 临床结果 临床结果
背景情况:
- 使用抗生素的非手术管理 (NOM) 已被确认为对儿科无并发性尾炎的安全和有效.
- 与尾切除术相比,NOM的相对成本效益在很大程度上仍未确定.
- 这项研究探讨了NOM与外科手术之间的经济影响.
研究的目的:
- 评估非手术治疗与手术治疗对儿科无并发性急性尾炎的成本效益.
- 在一年的时间内分析医疗费用,质量调整寿命年 (QALYs) 和残疾调整寿命年 (DALYs).
- 确定NOM在治疗儿科尾炎的经济可行性.
主要方法:
- 从医疗保健部门的角度进行基于试验的经济评估,使用来自多机构非随机对照试验的数据.
- 分析初次住院,再入院和急诊室访问费用,以及患者报告结果的实用数据.
- 包括多种情景和灵敏度分析来解决参数不确定性,每QALY或DALY的支付意愿门为100,000美元.
主要成果:
- 在1068名参与者中,370人 (35%) 接受了NOM,698人 (65%) 进行了腹腔镜尾切除术.
- NOM平均每名患者8044美元,QALY为0.895,而手术管理平均每名患者9791美元,QALY为0.884.
- 在基准病例和情景分析中,NOM被发现比手术更便宜,更有效.
结论:
- 与腹腔镜尾切除术相比,非手术治疗 (NOM) 是一个具有成本效益的策略,用于在一年内治疗儿科无并发性尾炎.
- 通过降低成本和产生更好的健康结果,NOM展示了卓越的价值.
- 这些发现支持NOM作为儿童无并发性尾炎的经济可行和临床有益的选择.
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