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德国临床判断与分子即时检测用于流感样疾病患者的成本-疾病比较。

Cost-of-illness comparison between clinical judgment and molecular point-of-care testing for influenza-like illness patients in Germany.

机构信息

Witten/Herdecke University, Witten, Germany.

bcmed GmbH, Ulm, Germany.

出版信息

NPJ Prim Care Respir Med. 2023 Jan 17;33(1):3. doi: 10.1038/s41533-022-00325-4.

DOI:10.1038/s41533-022-00325-4
PMID:36650143
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9844933/
Abstract

A high economic burden stems from seasonal influenza as a well-known but serious public health problem. Rapid diagnostic tests have not yet been integrated into routine use in German primary care, even though they are likely to reduce overall costs in cases of suspected infection. This study aims to demonstrate that the use of point-of-care testing (POCT) produces lower costs of illness compared to the costs incurred by relying on clinical judgment alone. With the help of a decision tree model, two different diagnostic approaches for influenza-like illness (ILI) in primary care were compared: (1) clinical judgment with no technical support and (2) POCT. The costs of illness, as well as their differences, vary widely among the three age groups considered (elderly people, adults, and children). For the pathway of using clinical judgment alone, the costs of illness sum up to 155.99 € for elderly people compared to 76.31 € for adults and 74.15 € for children. With POCT, the costs of illness for the elderly amount to 115,09 €, which is 26% lower than the costs without diagnostic support. The costs for adults and children are 74.42 € and 75.66 €, respectively, which means 2.5% lower costs of illness for adults and 2% higher costs for children. The results demonstrate that the use of POCT to support detecting influenza in ILI patients may reduce the overall cost of illness. The provided data can help governments make informed decisions about potential cost savings by integrating POCT into the reimbursement scheme.

摘要

季节性流感是一个众所周知但严重的公共卫生问题,其造成的经济负担沉重。尽管快速诊断检测可能会降低疑似感染病例的总体成本,但在德国初级保健中尚未将其纳入常规使用。本研究旨在证明与仅依赖临床判断相比,使用即时检测(POCT)可降低疾病成本。通过决策树模型,比较了初级保健中两种不同的流感样疾病(ILI)诊断方法:(1)无技术支持的临床判断,(2)POCT。疾病成本及其差异在考虑的三个年龄组(老年人、成年人和儿童)中差异很大。对于仅使用临床判断的途径,老年人的疾病总成本为 155.99 欧元,而成年人和儿童的疾病总成本分别为 76.31 欧元和 74.15 欧元。对于 POCT,老年人的疾病总成本为 115.09 欧元,比没有诊断支持的成本低 26%。成年人和儿童的成本分别为 74.42 欧元和 75.66 欧元,这意味着成年人的疾病成本降低了 2.5%,而儿童的疾病成本增加了 2%。结果表明,使用 POCT 支持检测 ILI 患者中的流感可能会降低总体疾病成本。提供的数据可以帮助政府通过将 POCT 纳入报销计划来做出有关潜在节省成本的明智决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/399e/9845217/3c834227a1b2/41533_2022_325_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/399e/9845217/3c834227a1b2/41533_2022_325_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/399e/9845217/3c834227a1b2/41533_2022_325_Fig1_HTML.jpg

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