协作性痴呆症照护管理的成本效益-一项群组随机对照试验的结果。
Cost-effectiveness of a collaborative dementia care management-Results of a cluster-randomized controlled trial.
机构信息
German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany; Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Canada.
Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Canada; Program for Health Economics and Outcome Measures (PHENOM), Hamilton, Canada.
出版信息
Alzheimers Dement. 2019 Oct;15(10):1296-1308. doi: 10.1016/j.jalz.2019.05.008. Epub 2019 Aug 10.
INTRODUCTION
The purpose of this study was to determine the cost-effectiveness of collaborative dementia care management (DCM).
METHODS
The cost-effectiveness analysis was based on the data of 444 patients of a cluster-randomized, controlled trial, conceptualized to evaluate a collaborative DCM that aimed to optimize treatment and care in dementia. Health-care resource use, costs, quality-adjusted life years (QALYs), and incremental cost per QALY gained were measured over a 24-month time horizon.
RESULTS
DCM increased QALYs (+0.05) and decreased costs (-569€) due to a lower hospitalization and a delayed institutionalization (7 months) compared with usual care. The probability of DCM being cost-effective was 88% at willingness-to-pay thresholds of 40,000€ per QALY gained and higher in patients living alone compared to those not living alone (96% vs. 26%).
DISCUSSION
DCM is likely to be a cost-effective strategy in treating dementia and thus beneficial for public health-care payers and patients, especially for those living alone.
简介
本研究旨在确定协作性痴呆症管理（DCM）的成本效益。
方法
该成本效益分析基于一项聚类随机对照试验的 444 名患者的数据，旨在评估一种协作性 DCM，旨在优化痴呆症的治疗和护理。在 24 个月的时间内测量了卫生保健资源的使用、成本、质量调整生命年（QALYs）和每获得一个 QALY 的增量成本。
结果
与常规护理相比，DCM 通过降低住院率和延迟住院（7 个月）增加了 QALYs（+0.05）并降低了成本（-569 欧元）。在意愿支付阈值为每获得一个 QALY 40,000 欧元及以上的情况下，DCM 的成本效益概率为 88%，独居患者比非独居患者更高（96%比 26%）。
讨论
DCM 可能是治疗痴呆症的一种具有成本效益的策略，因此对公共医疗保健支付者和患者有益，特别是对独居患者。
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