Optimax Access UK Ltd, University of Southampton Science Park, Chilworth Hampshire, UK.
Device Access UK Ltd, Market Access Consultancy, University of Southampton Science Park, Chilworth Hampshire, UK.
J Med Econ. 2020 Jul;23(7):728-736. doi: 10.1080/13696998.2020.1747474. Epub 2020 May 1.
Complications after surgical procedures are common and can lead to a prolonged hospital stay, increased rates of postoperative hospital readmission, and increased mortality. Monitoring vital signs is an effective way to identify patients who are experiencing a deterioration in health. SensiumVitals is wireless system that includes a lightweight, digital patch that monitors vital signs at two minute intervals, and has shown promise in the early identification of patients at high risk of deterioration. To evaluate the cost-utility of continuous monitoring of vital signs with SensiumVitals in addition to intermittent monitoring compared to the usual care of patients admitted to surgical wards. A decision analytic model, based on current treatment pathways, was developed to estimate the costs and outcomes. Results from randomised clinical trials and national standard sources were used to inform the model. Costs were estimated from the NHS and PSS perspective. Deterministic and probabilistic sensitivity analyses (PSA) were conducted to explore uncertainty surrounding input parameters. Over a 30-day time horizon, intermittent monitoring in addition to continuous monitoring of vital signs with SensiumVitals was less costly than intermittent vital signs monitoring alone. The total cost per patient was £6,329 versus £5,863 for the comparator and intervention groups respectively and the total effectiveness per patient was 0.057 QALYs in each group. Results from the PSA showed that use of SensiumVitals in addition to intermittent monitoring has 73% probability of being cost-effective at a £20,000 willingness-to-pay threshold and 73% probability of being cost-saving compared to the comparator. Cost savings were driven by reduced costs of hospital readmissions and length of stays in hospital. Use of SensiumVitals as a postoperative intervention for patients on surgical wards is a cost-saving and cost-effective strategy, yielding improvements in recovery with decreased health resource use.Key Points for Decision MakersSensiumVitals has the potential to reduce the length of postoperative hospital stay, readmission rates, and associated costs in postoperative patients.In this study, SensiumVitals has been found to be a cost-saving (dominant) and cost-effective (dominant) intervention for monitoring the vital signs of surgical patients postoperatively.
手术后的并发症很常见，可能导致住院时间延长、术后住院再入院率增加和死亡率增加。监测生命体征是识别健康状况恶化患者的有效方法。SensiumVitals 是一种无线系统，包括一个轻量级的数字贴片，可每两分钟监测一次生命体征，并已显示出在早期识别有恶化风险的患者方面具有潜力。评估与外科病房患者常规护理相比，使用 SensiumVitals 连续监测生命体征与间断监测相比的成本效益。基于当前治疗途径，开发了一个决策分析模型来估计成本和结果。随机临床试验和国家标准来源的结果用于为模型提供信息。从 NHS 和 PSS 的角度估算了成本。进行了确定性和概率敏感性分析 (PSA) 以探索输入参数的不确定性。在 30 天的时间范围内，与单独间断监测生命体征相比，连续监测生命体征与 SensiumVitals 联合使用的间断监测成本更低。每个患者的总成本分别为 6329 英镑和 5863 英镑，每个患者的总效果分别为 0.057 QALYs。PSA 的结果表明，与对照组相比，在 20000 英镑的意愿支付阈值下，SensiumVitals 的使用具有 73%的成本效益概率，并且具有 73%的成本节约概率。成本节约的驱动因素是医院再入院和住院时间的减少。将 SensiumVitals 用作外科病房患者的术后干预措施是一种节省成本且具有成本效益的策略，可通过减少健康资源的使用来改善康复效果。决策者要点SensiumVitals 有可能减少术后患者的住院时间、再入院率和相关成本。在这项研究中，SensiumVitals 被发现是一种节省成本（占主导地位）和具有成本效益（占主导地位）的干预措施，用于监测术后外科患者的生命体征。
