美国公共通道除器的潜在成本效益
G Nichol1, A P Hallstrom, J P Ornato
1Loeb Medical Research Institute, University of Ottawa, Canada.
Circulation
|May 7, 1998
概括
公共通道除动器 (PAD) 可能为突然心脏骤停提供良好的价值,尽管成本高于标准紧急医疗服务 (EMS). 需要进一步的试验来确认PAD干预措施的成本效益.
科学领域:
- 卫生经济学 卫生经济学
- 紧急医疗 紧急医疗
- 公共卫生干预 公共卫生干预
背景情况:
- 突然心脏骤停每年影响36万美国人,目前的治疗方法昂贵且无效.
- 公共通道除动器 (PAD) 是由非专业人士或警察使用的自动外部除动器,用于医院外的突然心脏骤停.
- PAD的经济价值仍然不清楚,需要进行成本效益分析.
研究的目的:
- 与标准紧急医疗服务 (EMS) 相比,估计公共通道除 (PAD) 的潜在成本效益.
- 评估涉及美国医疗保健系统中外界应急人员或警察的PAD干预措施.
主要方法:
- 一个决策模型将标准EMS与通过PAD补充的EMS进行了比较.
- 使用蒙特卡洛模拟和灵敏度分析来评估成本效益和可变性.
- 数据来源于已发表的文献和财政数据库,未来成本和影响的折扣率为3%.
主要成果:
- 标准的EMS平均每名患者的费用为5900美元,产生0.25个质量调整寿命年 (QALY).
- 没有响应者的PAD平均每QALY增加成本为44,000美元.
- 警方的PAD平均每QALY增加成本为27,200美元,结果对成本和生存效益敏感.
结论:
- PAD比标准的EMS更昂贵,但对于突然心脏骤停来说,它可能在经济上具有吸引力.
- 该研究建议在随机对照试验中评估PAD的有效性和成本效益.
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