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多用户接入与远程医疗家庭睡眠呼吸暂停测试在阻塞性睡眠呼吸暂停(OSA)诊断中的比较:一项成本最小化研究。

Multiple-access versus telemedicine home-based sleep apnea testing for obstructive sleep apnea (OSA) diagnosis: a cost-minimization study.

机构信息

Università Cattolica del Sacro Cuore, Rome, Italy.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

出版信息

Sleep Breath. 2022 Dec;26(4):1641-1647. doi: 10.1007/s11325-021-02527-5. Epub 2021 Nov 26.

Abstract

PURPOSE

The aim of the present study was to compare two clinical pathways: the multiple-access outpatient pathway versus the telemedicine pathway.

METHODS

The multiple-access outpatient pathway and the telemedicine pathway were both performed with WatchPAT and implemented in a real-life healthcare scenario, adopting a cost-minimization approach. A cost-minimization analysis was undertaken to assess the economic impact of the two alternatives. The cost analyses were performed in euros for the year 2021 adopting the patient, the hospital, and the societal perspectives. Given the chosen perspectives, direct medical costs, direct nonmedical costs, and indirect costs were considered. In addition, a univariate sensitivity analysis was conducted.

RESULTS

From a hospital perspective, the telemedicine approach was estimated to cost €49 more than the multiple-access alternative. Considering the patient perspective, the telemedicine approach was estimated to cost €167 less than the multiple-access pathway. Considering the societal perspective, the telemedicine approach is estimated to cost €119 less than the multiple-access pathway.

CONCLUSION

The adoption of telemedicine home sleep apnea testing could improve the efficiency of the healthcare processes if considering the direct and indirect costs incurred by patients and not only by healthcare providers.

摘要

目的

本研究旨在比较两种临床路径:多通道门诊路径与远程医疗路径。

方法

多通道门诊路径和远程医疗路径均通过 WatchPAT 实施,并在实际医疗场景中采用成本最小化方法。采用成本最小化分析评估两种替代方案的经济影响。成本分析以欧元为单位,针对 2021 年,采用患者、医院和社会三个角度。鉴于所选择的角度,考虑了直接医疗成本、直接非医疗成本和间接成本。此外,还进行了单变量敏感性分析。

结果

从医院角度来看,远程医疗方法的估计成本比多通道替代方案高出 49 欧元。从患者角度来看,远程医疗方法的估计成本比多通道途径低 167 欧元。从社会角度来看,远程医疗方法的估计成本比多通道途径低 119 欧元。

结论

如果考虑患者和医疗服务提供者产生的直接和间接成本,采用远程医疗家庭睡眠呼吸暂停测试可以提高医疗流程的效率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba8b/8617356/8a840d1878c3/11325_2021_2527_Fig1_HTML.jpg

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