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基于团队的护理经济学:血压控制社区指南系统评价更新。

Economics of Team-Based Care for Blood Pressure Control: Updated Community Guide Systematic Review.

机构信息

Community Guide Program, Office of Scientific Evidence and Recommendations, Office of Science, Centers for Disease Control and Prevention, Atlanta, Georgia.

Community Guide Program, Office of Scientific Evidence and Recommendations, Office of Science, Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

Am J Prev Med. 2023 Oct;65(4):735-754. doi: 10.1016/j.amepre.2023.04.013. Epub 2023 Apr 28.

Abstract

INTRODUCTION

This paper examined the recent evidence from economic evaluations of team-based care for controlling high blood pressure.

METHODS

The search covered studies published from January 2011 through January 2021 and was limited to those based in the U.S. and other high-income countries. This yielded 35 studies: 23 based in the U.S. and 12 based in other high-income countries. Analyses were conducted from May 2021 through February 2023. All monetary values reported are in 2020 U.S. dollars.

RESULTS

The median intervention cost per patient per year was $438 for U.S. studies and $299 for all studies. The median change in healthcare cost per patient per year after the intervention was -$140 for both U.S. studies and for all studies. The median net cost per patient per year was $439 for U.S. studies and $133 for all studies. The median cost per quality-adjusted life year gained was $12,897 for U.S. studies and $15,202 for all studies, which are below a conservative benchmark of $50,000 for cost-effectiveness.

DISCUSSION

Intervention cost and net cost were higher in the U.S. than in other high-income countries. Healthcare cost averted did not exceed intervention cost in most studies. The evidence shows that team-based care for blood pressure control is cost-effective, reaffirming the favorable cost-effectiveness conclusion reached in the 2015 systematic review.

摘要

简介

本文考察了近期关于基于团队的护理控制高血压的经济评估的证据。

方法

搜索范围涵盖了 2011 年 1 月至 2021 年 1 月发表的研究,仅限于美国和其他高收入国家的研究。共产生了 35 项研究:23 项来自美国,12 项来自其他高收入国家。分析于 2021 年 5 月至 2023 年 2 月进行。报告的所有货币价值均为 2020 年的美元。

结果

美国研究中每位患者每年的干预成本中位数为 438 美元,所有研究的中位数为 299 美元。干预后每位患者每年的医疗保健成本变化中位数为美国研究中为-140 美元,所有研究中为-140 美元。每位患者每年的净干预成本中位数为美国研究中为 439 美元,所有研究中为 133 美元。美国研究中每获得一个质量调整生命年的成本中位数为 12897 美元,所有研究中为 15202 美元,均低于成本效益的保守基准 50000 美元。

讨论

美国的干预成本和净成本高于其他高收入国家。在大多数研究中,节省的医疗保健成本并未超过干预成本。证据表明,团队式护理控制血压具有成本效益,再次证实了 2015 年系统评价得出的有利成本效益结论。

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