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脊柱操纵,运动和脊柱疼痛自我管理的成本效益
Brent D Leininger1, Karen M Kuntz2, James S Hodges3
1Integrative Health and Wellbeing Research Program Earl E. Bakken Center for Spirituality & Healing, University of Minnesota, Mayo Memorial Building C504, 420 Delaware Street, Minneapolis, MN, 55414, USA. lein0122@umn.edu.
脊柱操纵疗法 (SMT) 和运动疗法 (ET) 对背部和部疼痛的成本效益有所不同,具体取决于患者的年龄和病情持续时间. 家庭炼和咨询 (HEA) 的效果往往不那么好.
科学领域:
- 健康经济学
- 肌肉骨系统疾病
- 基于证据的医学
背景情况:
- 脊柱疼痛在美国是一个严重的医疗负担,许多治疗的成本效益尚不清楚.
- 估计背部和部疼痛干预措施的经济价值对于医疗资源分配至关重要.
研究的目的:
- 在美国估计脊椎操纵疗法 (SMT),监督运动疗法 (ET) 和家庭运动和建议 (HEA) 的成本效益.
- 在不同患者群体和疼痛特征中比较SMT,ET和HEA.
主要方法:
- 美国八项随机试验的个人参与者数据元分析.
- 从社会和医疗保健的角度计算增量成本效益比率 (ICER).
- 使用质量调整寿命年 (QALY) 作为主要结果指标.
主要成果:
- 与HEA相比,SMT对急性部疼痛和某些慢性疾病 (例如,慢性背部相关腿痛,老年人慢性部疼痛) 具有有利的成本效益.
- 与ET相比,SMT在成人和青少年慢性背痛以及成人慢性部疼痛方面具有成本效益.
- 与HEA相比,ET对成人慢性部疼痛具有潜在的成本效益,但对其他疾病和群体的发现有所不同.
结论:
- 脊椎疼痛SMT,ET和HEA的成本效益高度依赖于患者的人口统计学,疼痛持续时间和疼痛位置.
- 在特定的临床场景中,SMT和ET可以是高效的替代方案.
- 可能需要进一步的研究来完善各种脊椎疼痛的成本效益估计.
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