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挪威东南部养老院居民移动放射摄影服务的成本分析。

Cost analysis of mobile radiography services for nursing home residents in Southeast Norway.

作者信息

Kjelle Elin, Kleven Linn, Olerud Hilde Merete, Melberg Hans Olav

机构信息

Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.

Department of Clinical Research Support, Oslo University Hospital, Oslo, Norway.

出版信息

J Eval Clin Pract. 2019 Apr;25(2):275-281. doi: 10.1111/jep.13058. Epub 2018 Oct 26.

Abstract

RATIONALE, AIMS, AND OBJECTIVE: Telemedicine applications, such as a mobile radiography service, provide a new way of organizing healthcare services. In order to provide safe and personalised care for nursing home residents during X-ray examinations, mobile radiography services have been implemented. The objective of this study was to analyse the costs of X-ray examinations and treatments for nursing home residents when comparing hospital-based imaging with a combination of hospital-based imaging and a mobile radiography service in Southeast Norway.

METHODS

A decision model was developed using the software TreeAge Pro. The model included two alternatives: the mobile radiography service in combination with hospital-based imaging and hospital-based imaging alone. The treatment needed based on the examination results could be given either in the nursing home or at the hospital. Probabilities and costs in the model were derived from previous research, various reports, and hospital data from the Southeast region of Norway. Monte Carlo simulations of 1000 residents were run through the model, and statistical analyses were applied.

RESULTS

The analysis showed a mean cost of €2790 per resident for the hospital-based service alone. For mobile and hospital-based services combined, the mean cost was €1946 per resident, including examinations and the immediate treatment given. This difference in costs was significant (p < 0.001).

CONCLUSION

A mobile radiography service in nursing homes provides a safe, high quality health care service. The result of this study showed there was a 30% cost-reduction by implementing the mobile radiography service.

摘要

原理、目的和目标:远程医疗应用,如移动放射摄影服务,提供了一种组织医疗服务的新方式。为了在X射线检查期间为养老院居民提供安全且个性化的护理,已实施移动放射摄影服务。本研究的目的是比较挪威东南部基于医院的影像检查与基于医院的影像检查和移动放射摄影服务相结合的方式时,分析养老院居民X射线检查和治疗的成本。

方法

使用TreeAge Pro软件开发了一个决策模型。该模型包括两个方案:移动放射摄影服务与基于医院的影像检查相结合以及仅基于医院的影像检查。根据检查结果所需的治疗可在养老院或医院进行。模型中的概率和成本来自先前的研究、各种报告以及挪威东南部地区的医院数据。通过该模型对1000名居民进行了蒙特卡罗模拟,并应用了统计分析。

结果

分析表明,仅基于医院的服务每位居民的平均成本为2790欧元。对于移动和基于医院的服务相结合的情况,每位居民的平均成本为1946欧元,包括检查和立即进行的治疗。成本差异显著(p < 0.001)。

结论

养老院中的移动放射摄影服务提供了安全、高质量的医疗服务。本研究结果表明,实施移动放射摄影服务可降低30%的成本。

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