评估预防,检测和治疗在多种长期条件中的成本效益的决策分析模型:范围审查
Tazeen Tahsina1, Javad Jawan1, Derrick Bennett2
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK.
概括
对于多种长期条件 (MLTCs) 的决策分析模型往往无法捕捉复杂性. 需要先进的经济模型来有效地优先考虑针对这些条件的干预措施.
科学领域:
- 卫生经济学 卫生经济学
- 决策科学科学 决策科学
- 公共卫生 公共卫生
背景情况:
- 多重长期疾病 (MLTCs) 对医疗保健系统构成重大挑战.
- 成本效益模型对于评估MLTC干预措施至关重要.
研究的目的:
- 系统地审查和评估用于MLTC预防和治疗的决策分析模型的质量.
- 确定MLTCs当前建模方法中的差距.
主要方法:
- 在 MEDLINE 和 EMBASE 进行全面的文献搜索,截至 2024 年 7 月 15 日.
- 包括使用成本效益模型的研究,用于针对两个或更多长期疾病的干预措施.
- 选择经济模式的质量评估.
主要成果:
- 包括43项研究,大多数模型 (50%) 仅针对两个长期疾病.
- 马尔科夫状态过渡模型是最常见的 (70%),其次是微模拟 (12%) 和离散事件模拟/决策树 (9%).
- 在99%的研究中,质量调整后寿命年是主要的结果指标.
结论:
- 现有的模型往往缺乏复杂性来表示疾病之间的相互作用,患者异质性和终身轨迹.
- 迫切需要增强的经济模型,以更好地反映MLTC多方面的性质.
- 改进的模型对于对MLTC进行干预的高效和公平的优先考虑至关重要.
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