手术部位感染预防的成本效益分析:扩大范围
Agi McFarland1, Sarkis Manoukian2, Helen Mason2
1Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK. agi.mcfarland@stir.ac.uk.
Applied health economics and health policy
|December 5, 2025
概括
对手术部位感染 (SSI) 的增强感染预防和控制 (IPC) 计划显示出在NHS中改善结果和降低成本的潜力. 然而,成本效益因手术类型而异,并且对几个影响因素敏感.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 预防传染病 预防传染病
- 外科手术的结果
背景情况:
- 手术部位感染 (SSI) 对患者和医疗保健系统造成了巨大的负担,包括停留时间,发病率和死亡率的增加.
- 虽然感染预防和控制 (IPC) 计划可以减轻SSI风险和成本,但其成本效益需要进一步调查.
- 鼻腔感染成本评估 (ECONI) 研究为此分析提供了患者级数据.
研究的目的:
- 评估英国国家卫生服务 (NHS) 中增强的SSI预防策略的成本效益.
- 评估增强的IPC对成年手术患者的成本和质量调整寿命 (QALYs) 的影响.
- 将增强的IPC程序与特定外科手术的当前临床实践进行比较.
主要方法:
- 采用蒙特卡洛微模拟模型来评估成本效益 (每QALY的成本).
- 该模型分析了三种手术类型:冠状动脉旁路移植,关节整形和剖腹产.
- 使用概率敏感性分析,场景分析和替代公用事业估值集来探索不确定性.
主要成果:
- 在大多数手术和时间点中,增强的IPC通常会导致成本降低和QALY收益更高,而不是目前的措施.
- 该研究的发现对所采用的公用事业估值方法敏感.
- 场景分析显示,SSI率,IPC有效性和计划成本等因素影响了不同策略的优势.
结论:
- 对SSI进行增强的IPC计划可能会改善健康结果并节省成本.
- 然而,在所有手术类型和时间框架中,好处并不均.
- 成本效益取决于各种因素,需要在实施时仔细考虑.
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