临床决策支持的成本效益,以改善澳大利亚原住民的CKD结果
Winnie Chen1,2, Kirsten Howard2, Gillian Gorham1
1Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Kidney international reports
|February 24, 2025
概括
领地护理工具是提高慢性病 (CKD) 诊断和管理的成本效益,在澳大利亚偏远的北领地. 投资于这种临床决策支持工具可以改善患者的治疗结果并降低医疗保健成本.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 北领地 (NT) 面临着慢性病 (CKD) 和替代疗法 (KRT) 的高负担.
- 澳大利亚原住民在偏远的NT地区不成比例地受到CKD的影响.
- 需要有效的干预措施来改善这一群体的CKD诊断和管理.
研究的目的:
- 与常规护理相比,模拟领地护理临床决策支持 (CDS) 工具的成本效益.
- 评估改进的CKD诊断和管理对偏远NT地区患者的治疗结果和医疗保健成本的影响.
主要方法:
- 从医疗保健资助者的角度开发了一个马尔科夫队列模型.
- 该模型模拟了23,195名在偏远NT地区患有CKD或有CKD风险的人群 (89%的第一民族,平均年龄42岁).
- 采用了2017-2023年的数据,以15年的时间视野,评估了改善诊断,管理或两者的情景.
主要成果:
- 综合方法 (改进诊断和管理) 是最具成本效益的,ICER为每位患者96,684美元,避免KRT,每位患者30 086美元,避免死亡.
- 每个QALY获得的ICER从3427美元 (改善诊断和管理) 到63,486美元 (仅改善管理).
- 单独改善诊断的成本效益低于联合改善的成本效益.
结论:
- 区域脏护理CDS工具非常具有成本效益,因为它可以提高早期CKD诊断和最佳管理.
- 通过强有力的伙伴关系开发的CDS工具的投资得到了支持,以改善高CKD负担设置的结果.
- 这些发现突显了技术在解决偏远土著人口健康差异方面的潜力.
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