Richardson Gerald, Godfrey Lesley, Gravelle Hugh, Watt Ian
Centre for Health Economics, University of York, York, UK.
Br J Gen Pract. 2004 Oct;54(507):765-71.
Hypertension is a major public health concern and, as the population ages, the size of the problem is likely to increase. However, detection rates and treatment of hypertension have been low. The introduction of new guidelines for the detection and treatment of hypertension have been encouraged but without any consideration to their cost-effectiveness.
To assess the potential cost-effectiveness of implementing new guidelines for the treatment of hypertension in general practice.
Model examining the incremental costs and effects of the new guidelines compared with the old.
A large general practice in north Yorkshire.
Two thousand and twenty-three patients reporting for a new health patient check had the costs and outcomes under the old and new guidelines estimated.
Implementing new guidelines for the detection, management, and treatment of hypertension in a primary care setting is more costly than the implementation of previous guidelines, but more effective in reducing the risk of cardiovascular disease. The incremental cost per cardiovascular disease event avoided is ?30 000, although sensitivity analysis shows that the estimate is subject to considerable uncertainty.
Compared with previous guidelines, introducing new guidelines for the management and treatment of hypertension in new patients in general practice is likely to be cost-effective. However, the workforce implications for general practitioners (GPs) and practice nurses should be considered.
高血压是一个重大的公共卫生问题，并且随着人口老龄化，该问题的规模可能会扩大。然而，高血压的检出率和治疗率一直很低。人们鼓励引入高血压检测和治疗的新指南，但未考虑其成本效益。
评估在全科医疗中实施高血压治疗新指南的潜在成本效益。
比较新指南与旧指南的增量成本和效果的模型。
北约克郡的一家大型全科诊所。
对2023名前来进行新的健康检查的患者，估算新旧指南下的成本和结果。
在基层医疗环境中实施高血压检测、管理和治疗的新指南比实施先前的指南成本更高，但在降低心血管疾病风险方面更有效。避免每例心血管疾病事件的增量成本为30000英镑，尽管敏感性分析表明该估计存在相当大的不确定性。
与先前的指南相比，在全科医疗中为新患者引入高血压管理和治疗的新指南可能具有成本效益。然而，应考虑对全科医生（GP）和执业护士的劳动力影响。
