在荷兰医疗保健系统中对子性途径的患者级成本分析
Maura Leusder1, Hilco J van Elten2, Kees Ahaus3
1Department of Health Services, Management & Organization, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. leusder@eshpm.eur.nl.
概括
由于个性化护理和新技术,不孕不育治疗的成本有显著的变化. 一个细分的成本模型揭示了基于价值的医疗保健决策至关重要的患者级成本差异.
科学领域:
- 卫生经济学 卫生经济学
- 生殖医学 生殖医学
- 医疗保健管理的管理
背景情况:
- 卫生经济评估需要准确的成本数据.
- 目前荷兰的低生育率DRG没有捕捉到患者层面的成本变化或技术影响.
- 低生育率是一个日益严重的全球健康问题.
研究的目的:
- 开发一个细粒度,可扩展的成本模型,用于不孕症患者的治疗途径.
- 分析非生育性治疗的实际成本和持续时间.
- 在生育护理中为基于价值的决策提供信息.
主要方法:
- 基于时间驱动的基于活动的成本计算 (TDABC) 应用于4190个不孕症患者的生育途径.
- 过程挖掘用于分析荷兰医疗保健系统中的患者旅程.
- 开发一个微成本分析模型.
主要成果:
- 途径的成本差异很大 (平均为6,329欧元,最高为36,976欧元) 和持续时间 (平均为25.5个月,最高为8.59年).
- 在治疗和DRG中观察到高达65%的结构性成本变化.
- 患者级成本变化,在实验室阶段最高,与周期量,类型和方法相关 (例如,IVF/ICSI周期超过了DRG33%).
结论:
- 在IVF等生育治疗中,个性化和不断发展的技术导致了显著的成本变化.
- 患者和治疗层面的细粒度成本数据对于有效的决策,经济分析和政策制定至关重要.
- 提供建议,以减少130万欧元的途径成本,支持个性化护理.
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