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负压伤口疗法与传统敷料:意大利卫生技术评估评价。

Negative Pressure Wound Therapy and Traditional Dressing: An Italian Health Technology Assessment Evaluation.

机构信息

IIG Philips, 20126 Milan, Italy.

Ab Medica Spa, 20023 Cerro Maggiore, Italy.

出版信息

Int J Environ Res Public Health. 2023 Jan 29;20(3):2400. doi: 10.3390/ijerph20032400.

Abstract

This evaluation shows the main advantages related to the introduction of negative pressure wound therapy (NPWT) in Italian clinical practice for the management of incisions in vascular surgery in patients suffering from peripheral arterial disease (PAD) and at risk of postoperative complications, compared to treatment with traditional dressings. A health technology assessment (HTA) activity was conducted assuming the hospital perspective, within a 12-month time horizon. The nine EUnetHTA Core Model dimensions were deeply explored, using scientific evidence on the topic, real-life data, and healthcare professionals' perceptions. The evaluation shows that the use of NPWT has had a positive impact in terms of higher clinical effectiveness and safety profile. The process mapping highlights how NPWT allows a reduction of 2.5 hospitalization days compared with standard dressing, with the consequent benefits considering economic, organizational, and social aspects. A significant economic saving per patient emerged, with an overall optimization of the patient's clinical pathway, impacting positively on the hospital's capacity. The budget impact analysis shows that the higher number of patients treated with NPWT, the higher the economic advantages. Furthermore, assuming the patient's perspective, it would generate an overall reduction in social costs of 28%. In conclusion, the results of this study provide helpful evidence-based information to policymakers through examinations of the relative values of intervention, thus supporting the overall hospital and institutional decision-making process to define appropriate areas of investments, leading to the achievement of not only higher clinical outcomes, but also important social, economic, and organizational advantages.

摘要

本评估展示了在意大利临床实践中引入负压伤口治疗(NPWT)的主要优势,与传统敷料相比,NPWT 可用于治疗外周动脉疾病(PAD)患者血管手术后切口,降低术后并发症风险。该评估是在医院视角下,在 12 个月的时间范围内,针对血管外科手术后切口管理,基于 NPWT 与传统敷料的对比,开展的一项卫生技术评估(HTA)活动。评估深入探讨了欧盟净科技评估核心模型的九个维度,使用了关于该主题的科学证据、真实数据和医疗保健专业人员的意见。评估表明,NPWT 的使用在提高临床效果和安全性方面产生了积极影响。流程映射突出了 NPWT 如何与标准敷料相比减少 2.5 天的住院时间,从而在经济、组织和社会方面带来益处。每个患者的经济节省显著,患者的临床路径得到了整体优化,对医院的能力产生了积极影响。预算影响分析表明,接受 NPWT 治疗的患者数量越多,经济优势就越大。此外,从患者的角度来看,它将产生 28%的社会总成本降低。总之,这项研究的结果通过对干预措施的相对价值进行评估,为决策者提供了有帮助的基于证据的信息,从而支持整体医院和机构的决策过程,以确定适当的投资领域,不仅实现了更高的临床结果,还带来了重要的社会、经济和组织优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eda5/9915998/ca07e5c18cca/ijerph-20-02400-g001.jpg

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