模拟共享计划的成本效益,以促进结肠镜检查的完成
Rachel B Issaka1,2,3, Laura Matrajt4,5, Pedro Nascimento de Lima6
1Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington.
为异常便免疫化学测试 (FIT) 提供共享服务显著改善了结肠镜检查的完成,导致结肠直肠癌 (CRC) 病例和死亡人数减少. 这种干预措施具有成本效益,通过早期发现和预防节省医疗资源.
科学领域:
- 癌症学
- 公共卫生
- 健康经济学
背景情况:
- 通过便免疫化学测试 (FIT) 进行结肠直肠癌 (CRC) 查通常面临较低的后续结肠镜检查率.
- 运输障碍是FIT结果异常后错过后续预约的一个重要因素.
研究的目的:
- 评估一项旨在提高结肠镜检查完成率的共享车辆干预措施的有效性和成本效益.
- 模拟共享乘车支持对CRC发病率,死亡率和医疗保健成本的影响.
主要方法:
- 为了模拟基于人群的CRC查,采用了微观模拟模型 (CRC模拟人群发病率和自然史模型).
- 在异常FIT后的结肠镜完成率为35%,涉及40美元或100美元的共享费用.
- 模拟分析了终身结果,包括CRC病例,死亡,寿命增长 (LYG) 和相关成本.
主要成果:
- 通过100美元的共享车辆, 模拟队伍的结肠镜完成率从35%增加到70%.
- 这种干预与每1000人中CRC病例减少26. 3%和CRC死亡减少32. 5%.
- 这项干预每1000人产生24.9LYG,并且节省了成本,每1000人查后净节省了330,587美元.
结论:
- 在FIT结果异常后,共享乘车是克服运输障碍和改善结肠镜检查的成本有效策略.
- 癌症预防和早期检测的综合益处使得共享车辆支持成为基于人口的CRC查计划中的一个有价值的工具.
- 投资每次100美元的交通援助可以大大降低CRC负担和医疗费用.
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