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电子医嘱与给药系统在减少药物不良事件方面的成本效益

Cost-effectiveness of an electronic medication ordering and administration system in reducing adverse drug events.

作者信息

Wu Robert C, Laporte Audrey, Ungar Wendy J

机构信息

Department of Medicine, University of Toronto, and Division of General Internal Medicine, University Health Network, Toronto, Canada.

出版信息

J Eval Clin Pract. 2007 Jun;13(3):440-8. doi: 10.1111/j.1365-2753.2006.00738.x.

Abstract

OBJECTIVES

Adverse drug events (ADEs) are common and cause significant morbidity and mortality. Patient safety groups advocate the implementation of electronic medication order entry systems to reduce ADEs. However, these systems are costly, and there are limited data on their effectiveness. We conducted a study to examine the costs of introducing an electronic medication ordering and administration system and its potential impact on reducing ADEs.

METHODS

An incremental cost-effectiveness analysis was performed comparing an electronic medication ordering and administration system to the standard system used at a large health care institution over a 10-year time horizon. Estimates of effect were obtained from the literature. Cost data were obtained from a health care institution in Toronto, Canada.

RESULTS

The incremental cost-effectiveness of the new system was $12,700 (USD) per ADE prevented. The cost-effectiveness was found to be sensitive to the ADE rate, to the effectiveness of the new system, the cost of the system, and costs due to possible increase in doctor workload.

CONCLUSIONS

An electronic medication order entry and administration system could improve care by reducing adverse events. Unfortunately there are limited data on effectiveness of these systems at reducing ADEs. Further research is required to determine more precisely the potential economic benefit of this technology.

摘要

目的

药物不良事件(ADEs)很常见,会导致显著的发病率和死亡率。患者安全组织主张实施电子医嘱录入系统以减少药物不良事件。然而,这些系统成本高昂,且关于其有效性的数据有限。我们开展了一项研究,以考察引入电子医嘱开具与管理系统的成本及其对减少药物不良事件的潜在影响。

方法

进行了一项增量成本效益分析,将电子医嘱开具与管理系统与一家大型医疗机构使用的标准系统在10年时间范围内进行比较。效果估计值来自文献。成本数据来自加拿大多伦多的一家医疗机构。

结果

新系统的增量成本效益为每预防一例药物不良事件12,700美元(美元)。发现成本效益对药物不良事件发生率、新系统的有效性、系统成本以及因医生工作量可能增加而产生的成本敏感。

结论

电子医嘱录入与管理系统可通过减少不良事件来改善医疗护理。遗憾的是,关于这些系统在减少药物不良事件方面有效性的数据有限。需要进一步研究以更精确地确定该技术的潜在经济效益。

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