与常规做法相比,心力衰竭患者接种流感疫苗:基于模型的成本效益分析
Rong Liu1, Anushka Patel2, Hueiming Liu2
1The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia; Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, New South Wales, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia.
Vaccine
|August 3, 2025
概括
医院出院后为心力衰竭患者接种季节性流感疫苗是具有成本效益的,可以挽救生命并降低医疗保健成本. 这一策略可以预防严重疾病,住院和死亡,为医疗保健系统提供了显著的价值.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 心脏病学 心脏病学
背景情况:
- 患有心力衰竭 (HF) 的患者面临严重并发症,住院和季节性流感死亡的风险增加.
- 在公开资金决策中,流感疫苗接种在高风暴患者中的成本效益至关重要.
研究的目的:
- 评估季节性流感疫苗接种在中国医院出院后对心力衰竭患者的成本效益.
- 为了比较医院内疫苗接种计划与通常的护理,这通常涉及基于社区的疫苗接种转诊.
主要方法:
- 使用四个健康状态马尔科夫模型进行成本效益分析.
- 一个假设的心力衰竭患者队列从中国河南省的医院出院.
- 从卫生系统的角度对一年时间的分析,测量成本,类似流感的疾病 (ILI),再录取,死亡和质量调整后生命年 (QALYs).
主要成果:
- 疫苗接种策略每人每年花费2,456美元,而通常护理费用为2,899美元,与0.53个QALY相比,QALY为0.57.
- 该干预措施占主导地位,节省了443美元,并在12个月内为每位患者获得0.03个QALY.
- 在1000名患者中,接种疫苗预防了28例ILI病例,164例住院治疗和44例死亡,总成本节省了443,000美元.
结论:
- 在出院时为心力衰竭患者实施流感疫苗接种计划可以挽救生命.
- 这一战略有可能减少政府的整体医疗保健支出.
- 尽管有好处,但在出院后的常规流感疫苗接种在医院环境中并没有得到广泛的实践.
相关概念视频
01:30Heart Failure V: Medical Management
23
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
23
01:22Heart Failure VI: Adjunct Therapies
28
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
28
01:30Heart Failure VII: Nursing Interventions
139
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
139
01:21Rheumatic Heart Disease III: Medical Management
32
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
32
01:30Heart Failure IV: Classification and Diagnostic Evaluation
33
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
33
01:26Heart Failure III: Clinical Manifestations
47
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
47