在重症肺炎中对儿童施用氧化策略试验 (COAST) 的成本后果分析
Orlagh U Carroll1, Richard Grieve1, Sarah Kiguli2
1Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London United Kingdom.
PLOS global public health
|January 8, 2026
概括
高流量鼻腔治疗 (HFNT) 对于患有严重低氧症的儿童来说,比低流量氧 (LFO) 更昂贵. 对于较不严重的低氧症,HFNT和LFO都比允许的低氧症策略更昂贵.
科学领域:
- 儿科重症监护 儿科重症监护
- 卫生经济学 卫生经济学
- 呼吸系统药物 呼吸系统药物
背景情况:
- 补充氧气对于治疗儿童严重的肺炎和低氧症至关重要.
- 儿童氧气输送策略试验 (COAST) 调查了替代氧气输送方法.
- 在低收入和中等收入国家,这些策略的临床效益和成本的比较存在不确定性.
研究的目的:
- 对患有严重肺炎和低氧血症的儿童进行不同氧气输送策略的成本后果分析.
- 评估与高流量鼻腔疗法 (HFNT),低流量氧气 (LFO) 和容许性低氧症相关的资源利用和总成本.
- 为儿童呼吸系统护理的资源分配和临床决策提供信息.
主要方法:
- 利用了COAST试验的数据,包括28天随机化后的1,842名参与者.
- 衡量资源使用包括氧气输送系统,药物,血液制品,诊断和住院.
- 计算总成本和增量成本,根据治疗组之间的基线差异进行调整.
主要成果:
- 在严重的低氧症中,HFNT (393.04美元) 的成本明显高于LFO (218.73美元).
- 在低氧症中,HFNT (391.95美元) 和LFO (198.26美元) 比容许性低氧症 (167.80美元) 更昂贵.
- 高昂的设备和耗材成本推动了HFNT的支出;健康结果在各组之间是相似的.
结论:
- 与LFO相比,HFNT代表了严重的儿科低氧化症的更高成本干预.
- 容许性低氧化症是一种比HFNT或LFO更具成本效益的策略,用于患有低氧化症的儿童.
- 在资源有限的环境中,成本效益考虑对于优化氧气治疗至关重要.
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