Ravyn Dana, Ravyn Vipa, Lowney Rob, Ferraris Victor
J Contin Educ Health Prof. 2014 Spring;34 Suppl 1:S41-6. doi: 10.1002/chp.21236.
Investments in continuing medical education (CME) exceed $2 billion annually, but few studies report the economic impact of CME activities. Analysis of patient-level economic outcomes data is often not feasible. Accordingly, we developed a model to illustrate estimation of the potential economic impact associated with CME activity outcomes.
Outcomes impact analysis demonstrated how costs averted from a CME symposium that promoted prevention of bleeding-related complications (BRC) and reoperation for bleeding (RFB) in cardiac and thoracic operations could be estimated. Model parameter estimates were from published studies of costs associated with BRC and RFB. Operative volume estimates came from the Society of Thoracic Surgeons workforce data. The base case predicted 3 in 10 participants preventing one BRC or RFB in 2% or 1.5% of annual operations, respectively. Probabilistic sensitivity analysis (PSA) evaluated the effect of parameter uncertainty.
92% of participants (n = 133) self-reported commitment to change, a validated measure of behavior change. For BRC, estimates for costs averted were $1,502,769 (95% confidence interval [CI], $869,860-$2,359,068) for cardiac operations and $2,715,246 (95% CI, $1,590,308-$4,217,092) for thoracic operations. For RFB, the savings estimates were $2,233,988 (95% CI, $1,223,901-$3,648,719).
Our economic model demonstrates that application of CME-related learning to prevent bleeding complications may yield substantial cost savings. Model prediction of averted costs associated with CME allows estimation of the economic impact on outcomes in the absence of patient-level outcomes data related to CME activities.
每年对继续医学教育(CME)的投资超过20亿美元,但很少有研究报告继续医学教育活动的经济影响。对患者层面经济结果数据进行分析往往不可行。因此,我们开发了一个模型来说明对与继续医学教育活动结果相关的潜在经济影响的估计。
结果影响分析展示了如何估计因继续医学教育研讨会而避免的成本,该研讨会促进了心脏和胸科手术中出血相关并发症(BRC)的预防以及出血后再次手术(RFB)。模型参数估计来自已发表的关于BRC和RFB相关成本的研究。手术量估计来自胸外科医师协会的劳动力数据。基础案例预测,每10名参与者中有3人分别在每年2%或1.5%的手术中预防一次BRC或RFB。概率敏感性分析(PSA)评估了参数不确定性的影响。
92%的参与者(n = 133)自我报告有改变的承诺,这是一种经过验证的行为改变衡量指标。对于BRC,心脏手术避免的成本估计为1,502,769美元(95%置信区间[CI],869,860 - 2,359,068美元),胸科手术为2,715,246美元(95% CI,1,590,308 - 4,217,092美元)。对于RFB,节省估计为2,233,988美元(95% CI,1,223,901 - 3,648,719美元)。
我们的经济模型表明,将与继续医学教育相关的学习应用于预防出血并发症可能会节省大量成本。对与继续医学教育相关的避免成本的模型预测允许在缺乏与继续医学教育活动相关的患者层面结果数据的情况下估计对结果的经济影响。