Nutrition Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain.
Nutrition Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Clin Nutr. 2021 Feb;40(2):339-349. doi: 10.1016/j.clnu.2020.06.010. Epub 2020 Jun 20.
BACKGROUND & AIMS: Home parenteral nutrition (HPN) is indicated in patients with chronic intestinal failure. The aim of the current study was to review existing scientific literature of full or partial economic evaluations associated to HPN.
A bibliographic database search was undertaken in PubMed (MEDLINE), Embase and Scopus, complemented by a reference list search. We combined search terms regarding HPN and costs/health economics. The inclusion criteria included: a) population: all population and age groups; b) intervention: partial or full HPN; c) comparator: no parenteral nutrition, continued or intermittent hospital based PN, other nutritional interventions or no comparator; d) outcomes: cost outcomes and economic evaluations associated to HPN. A different quality assessment tool was used for each of the different type of economic approach.
Twenty-three papers were included in the final review. 21 were partial economic evaluations (16 cost-of-illness studies and 5 cost analyses), and 2 were full economic evaluations, both cost-utility analysis. Most studies investigated costs from a healthcare perspective (n = 18), therefore they included only direct costs. Three studies included personal costs for HPN patient. None of the studies included productivity costs.
Most scientific literature regarding the economic costs of HPN comes from partial economic evaluations, such as cost-of-illness studies and cost analysis. According to them, HPN is an expensive treatment, although cost saving when compared to hospital based parenteral nutrition (PN). Full economic evaluations proved HPN as being cost-effective than hospital based PN, however more research is needed to confirm this in all settings.
家庭肠外营养（HPN）适用于慢性肠衰竭患者。本研究旨在回顾与 HPN 相关的全或部分经济评估的现有科学文献。
在 PubMed（MEDLINE）、Embase 和 Scopus 中进行文献数据库检索，并辅以参考文献搜索。我们结合了关于 HPN 和成本/健康经济学的检索词。纳入标准包括：a）人群：所有人群和年龄组；b）干预措施：部分或全部 HPN；c）对照：无肠外营养、继续或间歇性住院肠外营养、其他营养干预或无对照；d）结局：与 HPN 相关的成本结局和经济评估。不同类型的经济方法使用不同的质量评估工具。
最终综述共纳入 23 篇论文。其中 21 篇为部分经济评估（16 篇疾病成本研究和 5 篇成本分析），2 篇为全经济评估，均为成本效用分析。大多数研究从医疗保健角度调查了成本（n=18），因此仅包括直接成本。有 3 项研究包括 HPN 患者的个人成本。没有研究包括生产力成本。
大多数关于 HPN 经济成本的科学文献来自部分经济评估，如疾病成本研究和成本分析。根据这些研究，HPN 是一种昂贵的治疗方法，尽管与住院肠外营养（PN）相比可以节省成本。全经济评估证明 HPN 比住院 PN 更具成本效益，但需要更多的研究来证实这一点。
