Nicolini Antonello, Stieglitz Sven, Bou-Khalil Pierre, Esquinas Antonio
Respiratory Diseases Unit, General Hospital, Via Terzi 43, 16039 Sestri Levante, Italy.
Department of Pulmonology and Cardiology, Petrus Hospital Academic Teaching, Wuppertal, Germany.
Respir Investig. 2018 May;56(3):207-213. doi: 10.1016/j.resinv.2017.12.011. Epub 2018 Feb 1.
The growing interest in the quality of patient care at the levels of the health care managers, insurance companies, and health professionals is evident. Further, the growing population requires good quality health services. In this review, we analyzed the cost-effectiveness of noninvasive ventilation (NIV) in an acute setting for the treatment of respiratory failure. The strength of this review is that it identified and summarized the most relevant studies regarding various aspects of the cost-utility of NIV in an acute setting. This is the first review that focuses on the importance of the skills and training of the team in the reduction of costs associated with NIV. However, the small number of studies, heterogeneity of quality, and different outcomes of the different studies are the greatest limitations of this review. In conclusion, although there is great variation in the data drawn from the literature, NIV seems to be a cost-effective tool, especially in specific patients (those with chronic obstructive pulmonary disease) for whom the addition of NIV improves outcomes and has a positive impact on this expenditure.
医疗保健管理人员、保险公司和医疗专业人员对患者护理质量的关注度日益提高,这一点显而易见。此外,不断增长的人口需要高质量的医疗服务。在本综述中,我们分析了急性情况下无创通气(NIV)治疗呼吸衰竭的成本效益。本综述的优势在于它识别并总结了关于急性情况下NIV成本效用各个方面的最相关研究。这是第一篇关注团队技能和培训在降低与NIV相关成本方面重要性的综述。然而,研究数量少、质量异质性以及不同研究的不同结果是本综述最大的局限性。总之,尽管从文献中获取的数据差异很大,但NIV似乎是一种具有成本效益的工具,特别是对于特定患者(慢性阻塞性肺疾病患者),添加NIV可改善治疗结果并对这项支出产生积极影响。