具有成本效益的家庭血压远程监测的先决条件:早期健康经济分析
Job van Steenkiste1,2,3, Pim van Dorst4,5, Daan Dohmen3
1Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands.
JMIR cardio
|May 9, 2025
概括
家庭远程血压监测 (HBPT) 可以在高血压管理中具有成本效益,但在面对面的访问中略有减少. 通过减少咨询或针对特定患者群体优化HBPT实施,提高了其经济可行性.
科学领域:
- 卫生经济学 卫生经济学
- 心血管疾病管理管理
- 数字健康数字健康
背景情况:
- 家庭血压远程监测 (HBPT) 提供了改善高血压管理中的遵守和医疗保健服务的潜力.
- 对于HBPT的成本效益实施的先决条件仍然不清楚.
研究的目的:
- 与标准高血压管理相比,量化HBPT的潜在成本效益.
- 从社会角度来看,确定了成本效益高的HBPT实施的关键因素.
主要方法:
- 开发了一种具有30年视野的决策分析马尔科夫模型,每个QALY的支付意愿门为20,000欧元.
- 该模型模拟了12个健康状态的1000名患者,将HBPT与不同门诊部 (OPD) 咨询频率的标准护理 (SOC) 进行比较.
- 进行了广泛的敏感性和场景分析,以确定成本效益的关键变量.
主要成果:
- 在基准案例分析中,HBPT没有成本效益 (ICER €20,386/QALY).
- 敏感性分析显示,HBPT变得具有成本效益,OPD面对面咨询减少到1.48/年,成本节省为1.18/年.
- 延长临床效果持续时间和针对年轻患者 (≤64岁) 显著改善了HBPT的ICER.
结论:
- 通过适度减少亲自OPD咨询,HBPT可以实现成本效益或节省成本的结果.
- 这些发现表明,HBPT可以通过高效的远程患者监测来优化高血压护理,从而改变传统的管理方法.
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