National Center for Health Statistics, Center for Disease Control and Prevention, Hyattsville, MD, USA.
J Allergy Clin Immunol. 2012 Mar;129(3 Suppl):S49-64. doi: 10.1016/j.jaci.2011.12.984.
Measures of healthcare utilization and indirect impact of asthma morbidity are used to assess clinical interventions and estimate cost.
National Institutes of Health institutes and other federal agencies convened an expert group to propose standardized measurement, collection, analysis, and reporting of healthcare utilization and cost outcomes in future asthma studies.
We used comprehensive literature reviews and expert opinion to compile a list of asthma healthcare utilization outcomes that we classified as core (required in future studies), supplemental (used according to study aims and standardized), and emerging (requiring validation and standardization). We also have identified methodology to assign cost to these outcomes. This work was discussed at an National Institutes of Health-organized workshop in March 2010 and finalized in September 2011.
We identified 3 ways to promote comparability across clinical trials for measures of healthcare utilization, resource use, and cost: (1) specify the study perspective (patient, clinician, payer, and society); (2) standardize the measurement period (ideally 12 months); and (3) use standard units to measure healthcare utilization and other asthma-related events.
Large clinical trials and observational studies should collect and report detailed information on healthcare utilization, intervention resources, and indirect impact of asthma, so that costs can be calculated and cost-effectiveness analyses can be conducted across several studies. Additional research is needed to develop standard, validated survey instruments for collection of provider-reported and participant-reported data regarding asthma-related health care.
医疗保健利用和哮喘发病率的间接影响的衡量标准用于评估临床干预措施并估算成本。
美国国立卫生研究院（NIH）及其它联邦机构召集专家组，提议对未来哮喘研究中医疗保健利用和成本结果进行标准化的测量、收集、分析和报告。
我们综合文献回顾和专家意见，编制了一份哮喘医疗保健利用结果清单，将其分为核心（未来研究中必需的）、补充（根据研究目的和标准化使用）和新兴（需要验证和标准化）类别。我们还确定了为这些结果分配成本的方法。这项工作在 2010 年 3 月由 NIH 组织的研讨会上进行了讨论，并在 2011 年 9 月最终确定。
我们确定了 3 种方法来促进临床试验中医疗保健利用、资源利用和成本措施的可比性：（1）指定研究视角（患者、临床医生、支付方和社会）；（2）标准化测量期（理想情况下为 12 个月）；（3）使用标准单位来衡量医疗保健利用和其它与哮喘相关的事件。
大型临床试验和观察性研究应收集和报告有关医疗保健利用、干预资源和哮喘间接影响的详细信息，以便计算成本并进行多项研究的成本效益分析。需要进一步研究以开发用于收集提供者报告和参与者报告的与哮喘相关的医疗保健数据的标准、经过验证的调查工具。
