预防踝关节扭伤复发计划的潜在节省：一项随机对照试验的经济评估。
Potential savings of a program to prevent ankle sprain recurrence: economic evaluation of a randomized controlled trial.
机构信息
Willem van Mechelen, Van der Boechorststraat 7, Amsterdam 1081 BT, Netherlands.
出版信息
Am J Sports Med. 2010 Nov;38(11):2194-200. doi: 10.1177/0363546510373470. Epub 2010 Aug 10.
BACKGROUND
The most common ankle injury is the lateral ankle sprain. Dutch annual sports-related ankle sprain costs can roughly be estimated at €187,200,000. Research has shown that proprioceptive training accounts for an approximated overall 50% reduction in ankle sprain recurrence rate.
HYPOTHESIS
An unsupervised proprioceptive training program to reduce the recurrence of lateral ankle sprains will reduce overall health care costs.
DESIGN
Cohort study (economic analysis); Level of evidence, 2.
METHODS
The study included 522 male and female athletes: 256 athletes (120 female and 136 male) in the intervention group, and 266 athletes (128 female and 138 male) in the control group. Both groups received treatment according to usual care. Athletes allocated to the intervention group received an 8-week proprioceptive training program in addition to usual care. Costs per athlete and costs per injured athlete were calculated. Costs related to ankle sprain recurrences were measured from a societal perspective using cost diaries. Bootstrapping was used to analyze the cost-effectiveness data. Follow-up was 1 year.
RESULTS
Mean total costs in the intervention group were €81 (standard deviation, €134) per athlete and €114 (€325) per injured athlete. Mean overall costs in the control group were €149 (€836) per athlete and €447 (€1403) per injured athlete. Statistically significant differences in total costs were found per athlete (mean difference, -€69; 95% confidence interval, -€200 to -€2) and per injured athlete (-€332; -€741 to -€62) in favor of the intervention group. A cost-effectiveness plane showed the effect of the intervention was larger and the costs were lower in the intervention group than the control group.
CONCLUSION
The use of a proprioceptive training program after usual care of an ankle sprain is cost-effective for the prevention of ankle sprain recurrences in comparison with usual care alone. In the Netherlands, an estimated annual €35.9 million in medical and lost productivity costs can be saved solely by advocating a proprioceptive training program as in the present study.
背景
最常见的踝关节损伤是外侧踝关节扭伤。荷兰每年与运动相关的踝关节扭伤的费用约为 1.872 亿欧元。研究表明，本体感觉训练可使踝关节扭伤复发率降低约 50%。
假设
未经监督的本体感觉训练方案可降低外侧踝关节扭伤的复发率，从而降低整体医疗保健成本。
设计
队列研究（经济分析）；证据水平，2 级。
方法
该研究纳入了 522 名男性和女性运动员：干预组 256 名运动员（120 名女性和 136 名男性），对照组 266 名运动员（128 名女性和 138 名男性）。两组均接受常规治疗。将运动员分配到干预组的运动员除接受常规治疗外，还接受为期 8 周的本体感觉训练计划。按每位运动员和每位受伤运动员计算成本。使用成本日记从社会角度测量与踝关节扭伤复发相关的成本。使用自举法分析成本效益数据。随访时间为 1 年。
结果
干预组每位运动员的平均总成本为 81 欧元（标准差，134 欧元），每位受伤运动员的总成本为 114 欧元（325 欧元）。对照组每位运动员的平均总成本为 149 欧元（836 欧元），每位受伤运动员的总成本为 447 欧元（1403 欧元）。按每位运动员（平均差异，-69 欧元；95%置信区间，-200 至-2 欧元）和每位受伤运动员（-332 欧元；-741 至-62 欧元）的差异有统计学意义，干预组的总成本较低。成本效益平面显示，与单独常规治疗相比，在常规治疗后使用本体感觉训练方案预防踝关节扭伤复发更具成本效益。在荷兰，仅通过倡导本研究中的本体感觉训练方案，估计每年可节省 3590 万欧元的医疗和生产力损失成本。
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