Saueressig Ulrich, Kwan Jonathan T C, De Cock Erwin, Sapède Claudine
Gemeinschaftspraxis, Wuppertal, Germany.
Blood Purif. 2008;26(6):537-46. doi: 10.1159/000171873. Epub 2008 Nov 7.
Background andMethods: A prospective, observational study in 12 German and UK dialysis centers which quantified personnel time for anemia treatment using erythropoiesis-stimulating agents (ESAs). Tasks directly observable were measured through the time-and-motion method; time for non-observable tasks was estimated by healthcare staff. Using activity-based costing methods, time was converted into monetary units. Modeling was used to estimate potential time and cost savings using once-monthly C.E.R.A., a continuous erythropoietin receptor activator.
For current ESAs in Germany and the UK, respectively: mean observed time was 1.67 and 2.67 min/patient/administration, corresponding to 31 and 42 days/year/center/100 patients; mean total time/center/100 patients/year was estimated at 79 and 95 days, equivalent to EUR 17,031 and GBP 18,739. Assuming 100% once-monthly C.E.R.A. uptake, the observed time/patient/year may decrease by 79 and 84% in Germany and the UK, respectively, compared with traditional ESAs.
Conversion to once-monthly C.E.R.A. may offer the potential to reduce time spent on ESA administration in hemodialysis centers.
背景与方法:在12个德国和英国的透析中心进行的一项前瞻性观察性研究,该研究对使用促红细胞生成素(ESA)治疗贫血的人员时间进行了量化。通过时间动作研究方法测量直接可观察到的任务;不可观察任务的时间由医护人员估计。使用基于活动的成本核算方法,将时间转换为货币单位。使用建模方法来估计使用每月一次的连续促红细胞生成素受体激活剂C.E.R.A.可能节省的时间和成本。
对于德国和英国目前使用的ESA,分别有:平均观察到的时间为每次给药每名患者1.67分钟和2.67分钟,分别相当于每年每个中心每100名患者31天和42天;估计每个中心每年每100名患者的总时间为79天和95天,分别相当于17,031欧元和18,739英镑。假设100%采用每月一次的C.E.R.A.,与传统ESA相比,德国和英国每名患者每年观察到的时间可能分别减少79%和84%。
改用每月一次的C.E.R.A.可能有潜力减少血液透析中心在ESA给药上花费的时间。