Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany.
Chair of Health Care Operations/Health Information Management (UNIKA-T), Faculty of Business and Economics, University of Augsburg, Augsburg, Germany.
Endoscopy. 2021 Feb;53(2):156-161. doi: 10.1055/a-1294-0427. Epub 2020 Oct 20.
Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed.
A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation.
ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing.
In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.
在 COVID-19 大流行后期阶段，保护内镜科室医护人员的感染预防策略正受到广泛讨论。本文旨在探讨常规内镜前检测和高风险个人防护装备（PPE）的成本效益。
建立了一个基于 10000 名无症状患者就诊于高容量中心的理论假设的模型。采用蒙特卡罗模拟法计算增量成本效益比（ICER）和每例内镜检查的绝对费用。
普遍检测的 ICER 值随流行率的增加而降低。对于较高的流行率（≥1%），常规内镜前检测联合使用高风险 PPE 的 ICER 值最低，而不进行普遍检测但常规使用高风险 PPE 的每例内镜检查费用最低。
一般来说，随着 COVID-19 流行率的上升，常规内镜前检测联合高风险 PPE 的成本效益会更高。
