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在荷兰社区药店中使用即时肾护理测试来预防抗生素相关住院的预算影响分析。

Budget Impact Analysis of a Renal Point-of-Care Test in Dutch Community Pharmacies to Prevent Antibiotic-Related Hospitalizations.

机构信息

Asc Academics, Westerhaven 13, 9718 AW, Groningen, The Netherlands.

Department of Nephrology, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

出版信息

Appl Health Econ Health Policy. 2019 Feb;17(1):55-63. doi: 10.1007/s40258-018-0426-2.

Abstract

OBJECTIVES

Medication errors that lead to adverse drug reactions are a key cause of unintentional patient harm and subsequent economic burden. To prevent this, measurement of renal function could be considered. The aim of this study was to determine the budget impact of obtaining and evaluating renal function in community pharmacies in the Netherlands to prevent antibiotic-related hospitalizations.

METHODS

A decision model was built to simulate the process of antibiotic prescriptions in community pharmacies with and without the use of a point-of-care test (PoCT) in patients aged 65 years and older. By using a PoCT, the number of patients with renal function values available increases, leading to the possibility of dose adjustment when necessary. In turn, this might avoid hospitalizations. For this study, real-life patient data were used from 351 community pharmacies. Direct costs of renal function screening, antibiotic treatments, and medical care due to antibiotic-related hospitalization were included.

RESULTS

The budget impact analysis showed annual cost-savings of €86 per patient through the availability of renal function values in Dutch community pharmacies. Savings were mostly due to avoided hospitalizations.

CONCLUSION

Obtaining and evaluating renal function in community pharmacies by point of care tests is expected to be cost-saving in the Netherlands.

摘要

目的

导致药物不良反应的用药错误是造成非故意患者伤害和后续经济负担的一个主要原因。为此,可以考虑对肾功能进行测量。本研究旨在确定在荷兰社区药房获取和评估肾功能以预防与抗生素相关的住院治疗的预算影响。

方法

建立了一个决策模型来模拟社区药房中抗生素处方的处理过程,同时考虑了是否使用即时检测(Point-of-care Test,PoCT)。通过使用 PoCT,肾功能值可用的患者数量增加,从而在必要时可以进行剂量调整,进而避免住院治疗。在这项研究中,使用了 351 家社区药房的真实患者数据。包括肾功能筛查、抗生素治疗和因抗生素相关住院治疗而产生的医疗费用的直接成本。

结果

通过在荷兰社区药房获得肾功能值,预算影响分析显示每位患者每年可节省 86 欧元。节省主要归因于避免了住院治疗。

结论

在荷兰,通过即时检测在社区药房中获取和评估肾功能有望节省成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd7a/6345725/5c9159a05e5c/40258_2018_426_Fig1_HTML.jpg

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