Department of Health Services, University of Washington, Seattle, WA, USA.
Department of Preventive Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
Eur J Health Econ. 2019 Dec;20(9):1409-1424. doi: 10.1007/s10198-019-01105-7. Epub 2019 Aug 26.
This systematic review examined the characteristics of published cost-effectiveness analyses of inpatient smoking cessation programs and assessed the methodological quality of the selected studies, to provide policymakers with economic evidence for this type of program.
A literature search was undertaken using a relevant database by three investigators. Only full economic evaluations with results in the form of the incremental cost-effectiveness ratio (ICER) were included. Costs were adjusted to 2016 US dollars using the Gross Domestic Product deflator and purchasing power parities. The British Medical Journal checklist was utilized to appraise the methodological quality of the included studies.
Nine articles were ultimately selected. The inpatient smoking cessation programs appeared to be a highly cost-effective intervention according to the recommended cost-effectiveness thresholds by the World Health Organization or individual studies. The highest ICERs among the selected studies were $5593 per additional quit, $10,550 per life year gained, and $5680 per quality-adjusted life year gained.
This study provides robust evidence supporting the cost-effectiveness of smoking cessation programs for hospitalized patients. In addition, the results indicated that the degree of cost-effectiveness of the inpatient smoking cessation program might not be related to either the components of the program or methodological variations in the cost-effectiveness analysis. Policymakers should provide hospitals with resources and strong incentives to promote wider implementation of the smoking cessation program.
本系统评价考察了已发表的住院戒烟计划成本效益分析的特点，并评估了所选研究的方法学质量，为决策者提供该类计划的经济证据。
由三名研究者使用相关数据库进行文献检索。仅纳入以增量成本效益比（ICER）形式呈现结果的全成本效益评估。使用国内生产总值平减指数和购买力平价将成本调整为 2016 年的美元。采用英国医学杂志清单评估纳入研究的方法学质量。
最终有 9 篇文章入选。根据世界卫生组织或个别研究推荐的成本效益阈值，住院戒烟计划似乎是一种极具成本效益的干预措施。所选研究中最高的增量成本效益比分别为每额外戒烟 5593 美元、每增加 1 个生命年 10550 美元和每增加 1 个质量调整生命年 5680 美元。
本研究为住院患者戒烟计划的成本效益提供了有力证据。此外，结果表明，住院戒烟计划的成本效益程度可能与该计划的组成部分或成本效益分析中的方法学差异无关。决策者应向医院提供资源和强有力的激励措施，以促进更广泛地实施戒烟计划。
