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手术干预治疗骨关节炎的成本效益:文献系统评价

Cost-effectiveness of surgical interventions for the management of osteoarthritis: a systematic review of the literature.

作者信息

Kamaruzaman Hanin, Kinghorn Philip, Oppong Raymond

机构信息

Malaysian Health Technology Assessment Section, Ministry of Health, Putrajaya, Malaysia.

Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

出版信息

BMC Musculoskelet Disord. 2017 May 10;18(1):183. doi: 10.1186/s12891-017-1540-2.

Abstract

BACKGROUND

The primary purpose of this study is to assess the existing evidence on the cost-effectiveness of surgical interventions for the management of knee and hip osteoarthritis by systematically reviewing published economic evaluation studies.

METHODS

A systematic review was conducted for the period 2004 to 2016. Electronic databases were searched to identify both trial and model based economic evaluation studies that evaluated surgical interventions for knee and hip osteoarthritis.

RESULTS

A total of 23 studies met the inclusion criteria and an assessment of these studies showed that total knee arthroplasty (TKA), and total hip arthroplasty (THA) showed evidence of cost-effectiveness and improvement in quality of life of the patients when compared to non-operative and non-surgical procedures. On the other hand, even though delaying TKA and THA may lead to some cost savings in the short-run, the results from the study showed that this was not a cost-effective option.

CONCLUSIONS

TKA and THA are cost-effective and should be recommended for the management of patients with end stage/severe knee and hip OA. However, there needs to be additional studies to assess the cost-effectiveness of other surgical interventions in order for definite conclusions to be reached.

摘要

背景

本研究的主要目的是通过系统回顾已发表的经济评估研究,评估手术干预治疗膝关节和髋关节骨关节炎的成本效益现有证据。

方法

对2004年至2016年期间进行了系统回顾。检索电子数据库,以识别评估膝关节和髋关节骨关节炎手术干预的基于试验和模型的经济评估研究。

结果

共有23项研究符合纳入标准,对这些研究的评估表明,与非手术和非外科手术相比,全膝关节置换术(TKA)和全髋关节置换术(THA)显示出成本效益证据以及患者生活质量的改善。另一方面,尽管延迟TKA和THA可能在短期内导致一些成本节约,但研究结果表明这不是一个具有成本效益的选择。

结论

TKA和THA具有成本效益,应推荐用于治疗终末期/重度膝关节和髋关节骨关节炎患者。然而,需要进行更多研究来评估其他手术干预的成本效益,以便得出明确结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2c4/5424321/94dc3ac510d3/12891_2017_1540_Fig1_HTML.jpg

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