在急诊室治疗原发性自发性肺胸部:一个成本效益分析
Margaret L Davis1, Jane Hall1, R Andrew Taylor2,3
1Department of Emergency Medicine, University of Washington, Seattle, Washington, USA.
概括
仅仅是观察是中度至严重的原发性自发性肺胸炎 (PSP) 最具成本效益的策略. 带有单向门的小孔胸管在PSP管理的干预选项中提供了最佳价值.
科学领域:
- 肺部医学 肺部医学
- 卫生经济学 卫生经济学
- 紧急医疗 紧急医疗
背景情况:
- 初级自发性肺胸炎 (PSP) 是健康个体的常见紧急情况,对中度至大度的崩造成管理挑战.
- 传统上,需要进行干预,但最近的试验发现了四种有效的策略:观察,针吸入,带有单向的小孔胸管和带有连续吸入的小孔胸管.
研究的目的:
- 为了比较四种不同的管理策略的成本效益中等到大的原发性自发性肺胸炎 (PSP) 在稳定的成人急诊室患者.
- 通过评估临床结果与经济价值一起,为临床决策提供信息.
主要方法:
- 从美国医疗保健系统的角度进行了成本效益分析.
- 一个具有终身视野的决策分析模型利用已发表的随机对照试验和二次数据.
- 计算了经质量调整的寿命年 (QALY),成本和净货币收益 (NMB),并进行了敏感性分析.
主要成果:
- 仅仅观察是最具成本效益的策略,产生了最高的NMB (43,696美元).
- 带有单向门的小孔胸管 (33,520美元),针吸入 (29,465美元) 和带有连续吸入的小孔胸管 (12,831美元) 在成本效益方面紧随其后.
- 敏感性分析证实观察是占主导地位的策略,受初始成功率的影响.
结论:
- 仅仅是观察是稳定,中等到大型PSP的最具成本效益的初始方法,尽管它的可行性需要考虑.
- 对于干预性管理,带有单向门的小孔胸管提供了最佳价值,并促进了门诊护理.
- 需要进一步的研究来验证在不同环境中仅观察治疗的有效性,并纳入患者特定因素.
关键词:
分析成本效益分析.决策分析建模的方法卫生经济学 卫生经济学针吸收是一种吸收方式.净货币收益 净货币收益 净货币收益观察 观察 观察原发性自发性肺胸.概率敏感性分析的概率敏感性分析小孔胸部管道小孔胸部管道更多相关视频
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