一个基于价值的评价的塞法佐林和万科米为假肢关节感染预防在全关节整形术的预防
Victoria E Bergstein1, Lauren C Lesser1, Walter L Taylor1
1Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA.
概括
塞法索林是一种更具成本效益的预防性抗生素,用于预防全关节整形术 (THA) 后的假肢关节感染 (PJI),而不是万科米辛. 这种差异是由较低的PJI率和较低的治疗成本驱动的,使得cefazolin成为基于价值的护理中首选的选择.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 卫生经济学 卫生经济学
背景情况:
- 在全关节整形术 (THA) 中,预防假肢关节感染 (PJI) 仍然是一个重大问题.
- 静脉注射抗生素预防的成本效益,特别是塞法林与万科米辛的成本效益,受到争议.
研究的目的:
- 为了比较Cefazolin和Vancomycin在THA中PJI预防的成本差异.
- 分析与每个预防剂相关的PJI管理成本的经济影响.
主要方法:
- 开发了一个成本模型,使用Cefazolin和Vancomycin的PJI公布率.
- 包括来自医院药房服务的药物采购成本和范科米管理的劳动力成本.
- PJI的成本是基于两阶段的败血性THA修订程序,并对未来的THA量进行了国家预测.
主要成果:
- 塞法林预防平均为每名患者1025.59美元,PJI率为0.75%.
- 范科米辛预防的平均费用为每名患者2710.82美元,PJI率为1.47%.
- 预计到2040年,预计的年度成本差异可能达到24亿美元.
结论:
- 由于更高的PJI率和相关的治疗费用,万科米辛的预防每位患者比塞法林更昂贵164%.
- 塞法林具有显著的成本优势,被认为是基于价值的护理环境中THA PJI预防的黄金标准.
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