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可溶性血管内皮生长因子受体1/胎盘生长因子比值作为意大利疑似子痫前期女性预测指标的预算影响分析

Budget impact analysis of sFlt-1/PlGF ratio as prediction test in Italian women with suspected preeclampsia.

作者信息

Frusca Tiziana, Gervasi Maria-Teresa, Paolini Davide, Dionisi Matteo, Ferre Francesca, Cetin Irene

机构信息

a Department of Obstetrics and Gynecology , University of Parma , Parma , Italy.

b Azienda Ospedaliera di Padova , Padova , Italy.

出版信息

J Matern Fetal Neonatal Med. 2017 Sep;30(18):2166-2173. doi: 10.1080/14767058.2016.1242122. Epub 2017 Feb 2.

Abstract

INTRODUCTION

Preeclampsia (PE) is a pregnancy disease which represents a leading cause of maternal and perinatal mortality and morbidity. Accurate prediction of PE risk could provide an increase in health benefits and better patient management.

OBJECTIVE

To estimate the economic impact of introducing Elecsys sFlt-1/PlGF ratio test, in addition to standard practice, for the prediction of PE in women with suspected PE in the Italian National Health Service (INHS).

METHODS

A decision tree model has been developed to simulate the progression of a cohort of pregnant women from the first presentation of clinical suspicion of PE in the second and third trimesters until delivery. The model provides an estimation of the financial impact of introducing sFlt-1/PlGF versus standard practice. Clinical inputs have been derived from PROGNOSIS study and from literature review, and validated by National Clinical Experts. Resources and unit costs have been obtained from Italian-specific sources.

RESULTS

Healthcare costs associated with the management of a pregnant woman with clinical suspicion of PE equal €2384 when following standard practice versus €1714 using sFlt-1/PlGF ratio test.

CONCLUSIONS

Introduction of sFlt-1/PlGF into hospital practice is cost-saving. Savings are generated primarily through improvement in diagnostic accuracy and reduction in unnecessary hospitalization for women before PE's onset.

摘要

引言

子痫前期(PE)是一种妊娠疾病,是孕产妇和围产期死亡及发病的主要原因。准确预测PE风险可增加健康益处并改善患者管理。

目的

评估在意大利国家医疗服务体系(INHS)中,除标准做法外,引入罗氏sFlt-1/PlGF比值检测对疑似PE孕妇预测PE的经济影响。

方法

开发了一个决策树模型,以模拟一组孕妇从妊娠中期和晚期首次出现临床疑似PE到分娩的病程进展。该模型估计了引入sFlt-1/PlGF与标准做法相比的财务影响。临床数据来源于PROGNOSIS研究和文献综述,并经国家临床专家验证。资源和单位成本来自意大利的特定来源。

结果

按照标准做法,对临床疑似PE孕妇进行管理的医疗费用为2384欧元,而使用sFlt-1/PlGF比值检测时为1714欧元。

结论

在医院实践中引入sFlt-1/PlGF可节省成本。节省主要通过提高诊断准确性和减少PE发作前女性不必要的住院来实现。

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