Arora M, Harvey L A, Glinsky J V, Chhabra H S, Hossain M S, Arumugam N, Bedi P K, Cameron I D, Hayes A J
John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.
Sydney Medical School Northern, The University of Sydney, Sydney, New South Wales, Australia.
Spinal Cord. 2017 Dec;55(12):1071-1078. doi: 10.1038/sc.2017.87. Epub 2017 Aug 15.
To determine from a societal perspective the cost-effectiveness and cost-utility of telephone-based support for management of pressure ulcers.
Cost-effectiveness and cost-utility analysis of a randomised clinical trial.
Tertiary centre in India and Bangladesh.
An economic evaluation was conducted alongside a randomised clinical trial comparing 12 weeks of telephone-based support (intervention group) with usual care (control group). The analyses evaluated costs and health outcomes in terms of cm reduction of pressure ulcers size and quality-adjusted life years (QALYs) gained. All costs were in Indian Rupees (INR) and then converted to US dollars (USD).
The mean (95% confidence interval) between-group difference for the reduction in size of pressure ulcers was 0.53 (-3.12 to 4.32) cm, favouring the intervention group. The corresponding QALYs were 0.027 (0.004-0.051), favouring the intervention group. The mean total cost per participant in the intervention group was INR 43 781 (USD 2460) compared to INR 42 561 (USD 2391) for the control group. The per participant cost of delivering the intervention was INR 2110 (USD 119). The incremental cost-effectiveness ratio was INR 2306 (USD 130) per additional cm reduction in the size of the pressure ulcer and INR 44 915 (USD 2523) per QALY gained.
In terms of QALYs, telephone-based support to help people manage pressure ulcers at home provides good value for money and has an 87% probability of being cost-effective, based on 3 times gross domestic product. Sensitivity analyses were performed using the overall cost data with and without productivity costs, and did not alter this conclusion.
从社会角度确定基于电话的压力性溃疡管理支持的成本效益和成本效用。
一项随机临床试验的成本效益和成本效用分析。
印度和孟加拉国的三级中心。
在一项随机临床试验的同时进行经济评估，该试验将12周的基于电话的支持（干预组）与常规护理（对照组）进行比较。分析从压力性溃疡大小减少的厘米数和获得的质量调整生命年（QALY）方面评估成本和健康结果。所有成本均以印度卢比（INR）计算，然后换算为美元（USD）。
压力性溃疡大小减少的组间平均（95%置信区间）差异为0.53（-3.12至4.32）厘米，有利于干预组。相应的QALY为0.027（0.004 - 0.051），有利于干预组。干预组每位参与者的平均总成本为43781印度卢比（2460美元），而对照组为42561印度卢比（2391美元）。提供干预措施的每位参与者成本为2110印度卢比（119美元）。每额外减少1厘米压力性溃疡大小的增量成本效益比为2306印度卢比（130美元），每获得1个QALY的增量成本效益比为44915印度卢比（2523美元）。
就QALY而言，基于电话的支持帮助人们在家中管理压力性溃疡具有良好的性价比，基于国内生产总值的3倍，具有87%的成本效益可能性。使用包含和不包含生产力成本的总体成本数据进行了敏感性分析，并未改变这一结论。
