皮肤冠状动脉干预患者不同治疗方法的成本效益分析:泰国PCI注册表
Oraluck Pattanaprateep1, Thosaphol Limpijankit2, Thunyarat Anothaisintawee1
1Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
概括
辐射接入和部分再血管化是穿皮冠状动脉干预 (PCI) 的成本效益高的策略. 设备引导的PCI显示每个效用收益的成本更高,这表明量身定制的干预措施可以优化患者的生活质量.
科学领域:
- 心血管医学 心血管医学
- 卫生经济学 卫生经济学
- 干预心脏病学 干预心脏病学
背景情况:
- 穿皮冠状动脉干预 (PCI) 的成本效益分析 (CUA) 对于理解经济价值至关重要.
- 对于发展中国家,CUA数据有限,这凸显了对资源特定经济评估的需要.
- 本研究解决了泰国PCI程序中的经济评估差距.
研究的目的:
- 为了比较不同的穿皮冠状动脉干预 (PCI) 治疗方式的成本效益.
- 为了评估辐射与大腿部接入,部分与完整的再血管化,以及设备引导与非设备引导的PCI.
- 在泰国医疗保健环境中,为资源分配提供信息并优化患者的治疗结果.
主要方法:
- 利用来自39家泰国医院 (n=7332) 的临床和生活质量数据.
- 对比了三种PCI方式:辐射/大腿部接入,部分/完全再血管化以及设备引导/非设备引导的程序.
- 用泰国EQ-5D-5L计算医院账单和公用事业的成本,计算一年的增量成本效益比率 (ICER).
主要成果:
- 与其他策略相比,辐射接入和部分再血管化与更低的成本和显著的效用收益有关.
- 设备引导的PCI产生了更高的成本 (+ 2004美元) 与更低的公用事业收益 (0.29在1年).
- 一年后的ICER为 -894美元的辐射接入, -359美元的部分再血管化,以及7041美元的设备引导PCI.
结论:
- 辐射接入和部分再血管化是具有成本效益的穿皮冠状动脉干预 (PCI) 策略.
- 损伤严重程度评估设备 (例如,FFR,IVUS,OCT) 与其实用性收益相比显示出高成本.
- 识别影响因素可以帮助定制PCI干预措施,以提高术后的生活质量.
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