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用于识别接受结直肠手术的手术部位感染风险患者的Caresyntax平台的成本效用分析。

Cost-Utility Analysis of the Caresyntax Platform to Identify Patients at Risk of Surgical Site Infection Undergoing Colorectal Surgery.

作者信息

Moloney Eoin, Mashayekhi Atefeh, Javanbakht Mehdi, Hemami Mohsen Rezaei, Branagan-Harris Michael

机构信息

Optimax Access Ltd., Kenneth Dibben House, Enterprise Rd, Chilworth, Southampton Science Park, Southampton, UK.

, Oxford, UK.

出版信息

Pharmacoecon Open. 2023 Mar;7(2):285-298. doi: 10.1007/s41669-023-00389-z. Epub 2023 Feb 3.

Abstract

BACKGROUND

Surgical site infections (SSIs) account for up to 18% of all healthcare-associated infections (HAIs). The Caresyntax data-driven surgery platform incorporates the most common risk factors for SSI, to identify high-risk surgical patients before they leave the operating theatre and treat them prophylactically with negative pressure wound therapy (NPWT). An economic analysis was performed to assess the costs and health outcomes associated with introduction of the technology in the English healthcare setting.

METHODS

A hybrid decision tree/Markov model was developed to reflect the treatment pathways that patients undergoing colorectal surgery would typically follow, both over the short term (30-day hospital setting) and long term (lifetime). The analysis considered implementation of Caresyntax's platform-based SSI predictive algorithm in the hospital setting, compared with standard of care, from an English National Health Service (NHS) perspective. The base-case analysis presents results in terms of cost per quality-adjusted life-year (QALY) gained, as well as operational impact.

RESULTS

The base-case analysis indicates that the intervention leads to a cost saving of £55.52m across the total NHS colorectal surgery patient population in 1 year. In addition, the intervention has a 98.36% probability of being cost effective over a lifetime horizon. The intervention results in the avoidance of 19,744 SSI events, as well 191,911 excess hospital bed days saved.

CONCLUSION

Caresyntax's platform-based SSI predictive algorithm has the potential to result in cost savings and improved patient quality of life. Additionally, operational gains for the healthcare provider, including reduced infection rates and hospital bed days saved, have been shown through the economic modeling.

摘要

背景

手术部位感染(SSIs)占所有医疗相关感染(HAIs)的比例高达18%。Caresyntax数据驱动手术平台纳入了手术部位感染最常见的风险因素,以便在高危手术患者离开手术室前识别出他们,并采用负压伤口治疗(NPWT)进行预防性治疗。开展了一项经济分析,以评估在英国医疗环境中引入该技术所产生的成本和健康结果。

方法

开发了一种混合决策树/马尔可夫模型,以反映结直肠手术患者在短期(30天住院期)和长期(终身)通常会遵循的治疗路径。该分析从英国国家医疗服务体系(NHS)的角度,考虑了在医院环境中实施Caresyntax基于平台的手术部位感染预测算法,并与标准治疗进行比较。基础案例分析给出了每获得一个质量调整生命年(QALY)的成本结果以及运营影响。

结果

基础案例分析表明,该干预措施在1年内为NHS结直肠手术患者总群体节省了5552万英镑的成本。此外,该干预措施在终身范围内具有成本效益的概率为98.36%。该干预措施避免了19744起手术部位感染事件,还节省了191911个额外的住院日。

结论

Caresyntax基于平台的手术部位感染预测算法有可能节省成本并改善患者生活质量。此外,通过经济建模已表明,该算法能为医疗服务提供者带来运营收益,包括降低感染率和节省住院日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb9d/10043121/9053ebe52dfb/41669_2023_389_Fig1_HTML.jpg

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