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移动X光摄影服务进入养老院——瑞典南部一项新医疗技术的经济评估

Radiography on wheels arrives to nursing homes - an economic assessment of a new health care technology in southern Sweden.

作者信息

Dozet Alexander, Ivarsson Bodil, Eklund Karin, Klefsgård Rosemarie, Geijer Mats

机构信息

Department of Healthcare Governance, Region Skåne, Malmö, Sweden.

Medicine Service University Trust, Region Skåne, Department of Cardiothoracic Surgery, Skåne University Hospital and Lund University, Lund, Sweden.

出版信息

J Eval Clin Pract. 2016 Dec;22(6):990-997. doi: 10.1111/jep.12590. Epub 2016 Jul 14.

Abstract

RATIONALE, AIMS AND OBJECTIVES: The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations.

METHODS

This prospective study included two groups of nursing home residents in two different areas in southern Sweden. All residents in the nursing homes were targeted for the study. Seventy-one patients were examined with hospital-based radiography at two hospitals, and 312 patients were examined using mobile radiography in nursing homes. Given that the diagnostic effects are regarded as equivalent, a cost minimization method was applied. Direct costs were estimated using prices from the county council, Region Skåne, Sweden.

RESULTS

From a societal perspective, mobile radiography was shown to have significantly lower costs per examination compared with hospital-based radiography. The difference in health care-related costs was also significant in favour of mobile radiography.

CONCLUSION

Mobile radiography can be used to examine patients in nursing homes at a lower cost than hospital-based radiography. Patients benefit from not having to transfer to a hospital for radiography, resulting in reduced anxiety for patients.

摘要

原理、目的和目标:将年长、体弱的成年人从老年护理机构转至医院接受医疗护理的过程,在情感和身体上可能会带来压力。现代移动放射成像技术的最新发展,通过在养老院本身进行评估,可能有助于缓解这种焦虑。截至目前,瑞典尚未尝试对该技术进行卫生经济学评估。本研究的目的是从社会角度确定,与基于医院的放射检查相比,在老年护理机构对患者进行移动放射成像检查是否具有成本效益。

方法

这项前瞻性研究纳入了瑞典南部两个不同地区的两组养老院居民。养老院的所有居民均为研究对象。71名患者在两家医院接受了基于医院的放射检查,312名患者在养老院接受了移动放射成像检查。鉴于诊断效果被认为是等效的,采用了成本最小化方法。直接成本使用瑞典斯科讷地区议会的价格进行估算。

结果

从社会角度来看,移动放射成像检查每次的成本显著低于基于医院的放射检查。与移动放射成像检查相比,医疗相关成本的差异也明显有利于移动放射成像检查。

结论

移动放射成像可用于在养老院检查患者,成本低于基于医院的放射检查。患者无需转至医院进行放射检查,从而减轻了焦虑。

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