Katsumura Yuichi, Yasunaga Hideo, Imamura Tomoaki, Oyama Hiroshi, Ohe Kazuhiko
Department of Health Informatics, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo.
Nihon Koshu Eisei Zasshi. 2007 Jul;54(7):447-53.
In recent years, medical safety has become a great concern to Japanese citizens. Many healthcare programs have been introduced in consequence, and beneficial effects have been repeatedly confirmed. However, hospitals need to make considerable investments for such programs and it is often difficult for healthcare administrators to judge which program should be given priority under budgetary constraints.
The purposes of this study were to review original articles on economic evaluation of medical safety management, to evaluate their quality levels, and to offer information for judgment by decision makers.
Using criteria including full economic evaluation we searched for original articles in the following electronic databases: MEDLINE; the Cochrane Library; the NHS Economic Evaluation Database 2005; and the Ichushi website. Then, we evaluated the quality of the economic studies found using the check list established by Drummond and others (1997).
Five papers met the inclusion criteria. Three covered infection control, one adverse drug events and one blood transfusions.
Economic evaluation of medical safety management has not been fully demonstrated. Cost-effectiveness of medical safety management has not been fully elucidated. It is necessary to perform economic studies of medical safety management, evaluate quality, and provide information useful for medical decision making.
近年来,医疗安全已成为日本民众极为关注的问题。因此,许多医疗保健项目纷纷出台,其有益效果也得到了反复证实。然而,医院需要为这些项目投入大量资金,而且在预算限制下,医疗保健管理人员往往难以判断应优先实施哪个项目。
本研究旨在回顾有关医疗安全管理经济评估的原创文章,评估其质量水平,并为决策者提供判断信息。
我们使用包括全面经济评估在内的标准,在以下电子数据库中搜索原创文章:MEDLINE;考克兰图书馆;2005年英国国家医疗服务体系经济评估数据库;以及医心网。然后,我们使用德拉蒙德等人(1997年)制定的检查表评估所发现的经济研究的质量。
五篇论文符合纳入标准。其中三篇涉及感染控制,一篇涉及药物不良事件,一篇涉及输血。
医疗安全管理的经济评估尚未得到充分论证。医疗安全管理的成本效益尚未得到充分阐明。有必要开展医疗安全管理的经济研究,评估质量,并提供有助于医疗决策的信息。