Department of Oral Surgery, School of Medicine, Toho University, Tokyo 143-8541, Japan.
Department of Oral & Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo 113-0034, Japan.
Int J Environ Res Public Health. 2021 Jul 13;18(14):7453. doi: 10.3390/ijerph18147453.
In April 2012, perioperative oral management (POM) was approved for inclusion in the national health insurance system of Japan to prevent the occurrence of pneumonia, a major complication in cancer patients. The subsequent decrease in the incidence of postoperative pneumonia indicated the prophylactic effect of POM. The constant increase in health expenditure necessitates a cost-effectiveness analysis. In addition, the effect of reducing healthcare costs owing to health technologies must be evaluated. In the present multi-institutional study, the cost-effectiveness analysis of POM was conducted by comparing the incidence of postoperative pneumonia and the healthcare costs between patients who received surgery for malignant tumors before ( = 11,886) and after ( = 13,668) the introduction of POM. Additionally, the effect of reducing healthcare costs was evaluated. Reductions in the number of patients who developed pneumonia, duration of hospitalization, and number of deaths were observed after the introduction of POM. The incremental cost-effectiveness ratio was 111,927 yen, hence the prevention of postoperative pneumonia needs 111,927 yen per patient in healthcare costs. Consequently, a maximum reduction of 250,368,129 yen in healthcare costs was observed between the incremental costs for pneumonia treatment and the cost of POM. These findings indicate that improvements in cost-effectiveness can be expected in the future through the development of procedure and system for POM.
2012 年 4 月，围手术期口腔管理（POM）被批准纳入日本国家健康保险体系，以预防癌症患者的主要并发症——肺炎的发生。随后术后肺炎发病率的下降表明了 POM 的预防效果。不断增加的卫生支出需要进行成本效益分析。此外，必须评估因卫生技术而降低医疗保健成本的效果。在本多机构研究中，通过比较接受恶性肿瘤手术的患者在引入 POM 前后（=11886 例）术后肺炎发生率和医疗保健成本，对 POM 的成本效益进行了分析。此外，还评估了降低医疗保健成本的效果。引入 POM 后，肺炎患者数量、住院时间和死亡人数减少。增量成本效益比为 111927 日元，因此预防术后肺炎需要在医疗保健成本中为每位患者支付 111927 日元。因此，在肺炎治疗的增量成本和 POM 的成本之间，观察到医疗保健成本最多可减少 250368129 日元。这些发现表明，通过开发 POM 的程序和系统，未来的成本效益有望得到改善。
