Pink Joshua, Petrou Stavros, Williamson Esther, Williams Mark, Lamb Sarah E
Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, Medical Sciences Division, University of Oxford, Oxford, UK..
Spine (Phila Pa 1976). 2016 Sep;41(17):1378-1386. doi: 10.1097/BRS.0000000000001512.
This study examines the links between severity of whiplash associated disorder and costs and health outcomes.
The study aims to estimate the economic costs and health-state utilities associated with disability levels and recovery trajectories after acute whiplash injury.
Data used were from the Managing Injuries of the Neck Trial, which collected information on 3851 people over a 12-month period after acute whiplash injury.
Effects of whiplash associated disorder severity on economic costs (measured from a societal perspective and separately from a health and personal social services perspective) were estimated using two-part regression models, comprising probability of incurring a cost and the total cost, given one was incurred. Effects on health-state utilities (measured using the EQ-5D and SF-6D) were estimated using ordinary least squares regression, and two-part models as for costs.
There was a direct relationship between severity of disability after acute whiplash injury and economic costs. Between baseline and 4 months, average societal costs for those with no disability were £99.55 (UK£, 2009 prices), increasing to £668.53 for those with complete disability. Average societal costs for the whole sample were £234.15 over the first 4 months, decreasing to £127.51 between 8 and 12 months. Conversely, utility scores decreased with increased disability. The average EQ-5D utility score was 0.934 at 4 months for those with no disability, decreasing to 0.033 for those with complete disability. The average EQ-5D utility score for the whole sample increased from 0.587 immediately post-injury to 0.817 at 12 months. Relative costs and disutilities generated by the multivariate models are also presented by disability level and recovery trajectory.
These results provide estimates of the costs and health-state utilities associated with disability levels and recovery trajectories after acute whiplash injury. They can be used to inform estimates of the cost-effectiveness of interventions targeting whiplash-associated disorders.
本研究探讨挥鞭样损伤相关疾病的严重程度与成本及健康结局之间的联系。
本研究旨在估计急性挥鞭样损伤后与残疾水平及恢复轨迹相关的经济成本和健康状态效用。
所用数据来自颈部损伤管理试验，该试验在急性挥鞭样损伤后的12个月内收集了3851人的信息。
使用两部分回归模型估计挥鞭样损伤相关疾病严重程度对经济成本（从社会角度以及分别从卫生和个人社会服务角度衡量）的影响，该模型包括产生成本的概率以及给定已产生成本情况下的总成本。使用普通最小二乘法回归以及与成本模型相同的两部分模型估计对健康状态效用（使用EQ-5D和SF-6D测量）的影响。
急性挥鞭样损伤后残疾严重程度与经济成本之间存在直接关系。在基线至4个月期间，无残疾者的平均社会成本为99.55英镑（2009年英国英镑价格），完全残疾者则增至668.53英镑。整个样本在最初4个月的平均社会成本为234.15英镑，在8至12个月期间降至127.51英镑。相反，效用得分随残疾程度增加而降低。无残疾者在4个月时的平均EQ-5D效用得分为0.934，完全残疾者则降至0.033。整个样本的平均EQ-5D效用得分从受伤后即刻的0.587增至12个月时的0.817。多变量模型产生的相对成本和负效用也按残疾水平和恢复轨迹列出。
这些结果提供了急性挥鞭样损伤后与残疾水平及恢复轨迹相关的成本和健康状态效用的估计值。它们可用于为针对挥鞭样损伤相关疾病的干预措施的成本效益估计提供信息。
3级。
