拉丁美洲急性缺血性中风的成本评估:一个多中心研究
Luiza Borba Dittrich1,2, Ana Paula Beck da Silva Etges2,3, Joana Siqueira de Souza1
1Graduate Program in Industrial Engineering, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Lancet regional health. Americas
|December 24, 2024
概括
在拉丁美洲,急性缺血性中风的护理费用差异很大. 机械血栓切除术的成本是医疗治疗的3.1倍,这凸显了医疗保健支出中的差异.
科学领域:
- 卫生经济学 卫生经济学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 目前的文献显示,拉丁美洲缺乏精确的中风成本数据.
- 这项研究通过测量急性缺血性中风护理的实际成本来弥补这一差距.
- 这些发现旨在支持该地区采用基于价值的医疗保健 (VBHC) 战略.
研究的目的:
- 测量拉丁美洲急性缺血性中风护理相关的直接成本.
- 分析基于治疗干预措施,临床风险和患者结果的成本变化.
- 提供数据,以告知卫生政策,改善中风护理的可持续性.
主要方法:
- 对急性缺血性中风患者的直接成本和结果进行了观察性,多中心的国际分析.
- 从拉丁美洲八个国家的中风中心收集的数据 (2021年12月至2022年12月).
- 基于时间驱动的活动成本计算 (TDABC) 和通用估计方程 (GEE) 模型被用于分析成本和临床变量.
主要成果:
- 包括1106名患者;74%接受了医疗治疗,18%的静脉血栓溶解 (IVT),4%的机械血栓切除术 (MT) 和3%的联合IVT+MT.
- 每名患者的平均成本为12,203美元;49%的人取得了有利的功能结果 (mRS 0-2).
- 机械血栓切除术 (MT) 的费用是仅仅医疗治疗的3.1倍 (增量费用为每名患者20,418美元;p < 0.0001),住院时间是主要的成本驱动因素.
结论:
- 在拉丁美洲,中风护理费用存在显著差异,受治疗可及性,患者结果和临床风险的影响.
- 调查结果为卫生政策决策提供了必要的见解,以提高中风护理的长期可持续性.
- 该研究为该地区基于价值的医疗保健采用奠定了基础.
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