一项真实世界证据研究：评估在标准治疗基础上添加Aerobika振荡呼气末正压装置对术后患者医疗资源利用和成本的影响。
A Real-World Evidence Study Assessing the Impact of Adding the Aerobika Oscillating Positive Expiratory Pressure Device to Standard of Care Upon Healthcare Resource Utilization and Costs in Post-Operative Patients.
作者信息
Burudpakdee Chakkarin, Near Aimee M, Huang Huan, Coppolo Dominic, Kushnarev Vladimir, Suggett Jason
机构信息
IQVIA, Fairfax, VA, USA.
Monaghan Medical Corporation, Syracuse, NY, USA.
出版信息
Pulm Ther. 2018 Jun;4(1):87-101. doi: 10.1007/s41030-018-0055-9. Epub 2018 May 16.
INTRODUCTION
The aim of this real-world study was to measure the benefit of the Aerobika oscillating positive expiratory pressure (OPEP) device when added to standard of care (defined as incentive spirometry [IS]) for post-operative patients.
METHODS
Adults aged ≥ 18 years who were hospitalized for cardiac, thoracic or upper abdominal surgery between 1 September 2013 and 30 April 2017 were identified from IQVIA's Hospital Charge Detail Master (CDM) database; the index date was the date of the first hospitalization for surgery. The control cohort (IS) included patients who had ≥ 1 CDM record within 12 months prior to the index date and ≥ 1 record after discharge, evidence of IS use during index hospitalization and no evidence of use of a PEP or OPEP device at any time during the study period. The Aerobika OPEP cohort was selected in a similar manner, except that patients were required to have evidence of Aerobika OPEP use during the index hospitalization. Aerobika OPEP patients were 1:1 matched to IS patients using propensity score (PS) matching. Hospital readmissions and costs were measured at 30 days post-discharge from the index hospitalization.
RESULTS
After PS matching, 144 patients were included in each cohort. At 30 days post-discharge, compared to the control (IS) cohort there were significantly fewer patients in the Aerobika OPEP cohort with ≥ 1 all-cause re-hospitalizations (13.9 vs. 22.9%; p = 0.042). The patients in the Aerobika OPEP cohort also had a shorter mean length of stay (± standard deviation) (1.25 ± 4.04 vs. 2.60 ± 8.24 days; p = 0.047) and lower total unadjusted mean all-cause cost per patient ($3670 ± $13,894 vs. $13,775 ± $84,238; p = 0.057). Adjusted analyses suggested that hospitalization costs were 80% lower for the Aerobika OPEP cohort versus the IS cohort (p = 0.001).
CONCLUSION
Our results suggest that the addition of the Aerobika OPEP device to standard of care (IS) is beneficial in the post-operative setting.
FUNDING
Trudell Medical International.
引言
本真实世界研究的目的是评估在标准护理（定义为激励式肺量计[IS]）基础上，为术后患者添加Aerobika振荡呼气末正压（OPEP）装置的益处。
方法
从IQVIA的医院收费明细主数据库（CDM）中识别出2013年9月1日至2017年4月30日期间因心脏、胸科或上腹部手术住院的年龄≥18岁的成年人；索引日期为首次手术住院日期。对照组（IS）包括在索引日期前12个月内有≥1条CDM记录且出院后有≥1条记录、索引住院期间有IS使用证据且在研究期间任何时候均无PEP或OPEP装置使用证据的患者。Aerobika OPEP组以类似方式选择，不同之处在于患者在索引住院期间需有Aerobika OPEP使用证据。使用倾向评分（PS）匹配将Aerobika OPEP患者与IS患者进行1:1匹配。在索引住院出院后30天测量医院再入院情况和费用。
结果
PS匹配后，每组纳入144例患者。出院后30天，与对照组（IS）相比，Aerobika OPEP组中全因再住院≥1次的患者明显更少（13.9%对22.9%；p = 0.042）。Aerobika OPEP组患者的平均住院时间（±标准差）也更短（1.25±4.04天对2.60±8.24天；p = 0.047），且每位患者的全因总未调整平均费用更低（3670美元±13894美元对13775美元±84238美元；p = 0.057）。调整分析表明，Aerobika OPEP组的住院费用比IS组低80%（p = 0.001）。
结论
我们的结果表明，在标准护理（IS）基础上添加Aerobika OPEP装置在术后环境中是有益的。
资助
Trudell Medical International。
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