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银屑病价值(IRIS)试验:在银屑病管理中实施基于价值的医疗保健——一项为期 1 年的前瞻性临床研究,以评估可行性和价值创造。

Value in psoriasis (IRIS) trial: implementing value-based healthcare in psoriasis management - a 1-year prospective clinical study to evaluate feasibility and value creation.

机构信息

Dermatology Research Unit (DRU), Ghent University, Ghent, Belgium.

Department of Dermatology, University Hospital Ghent, Ghent, Belgium.

出版信息

BMJ Open. 2023 May 23;13(5):e067504. doi: 10.1136/bmjopen-2022-067504.

Abstract

INTRODUCTION

Currently, the healthcare sector is under tremendous financial pressure, and many acknowledge that a dramatic shift is required as the current system is not sustainable. Furthermore, the quality of care that is delivered varies strongly. Several solutions have been proposed of which the conceptual framework known as value-based healthcare (VBHC) is further explored in this study for psoriasis. Psoriasis is a chronic inflammatory skin disease, which is associated with a high disease burden and high treatment costs. The objective of this study is to investigate the feasibility of using the VBHC framework for the management of psoriasis.

METHODS AND ANALYSIS

This is a prospective clinical study in which new patients attending the psoriasis clinic (PsoPlus) of the Ghent University Hospital will be followed up during a period of 1 year. The main outcome is to determine the value created for psoriasis patients. The created value will be considered as a reflection of the evolution of the value score (ie, the weighted outputs (outcomes) divided by weighted inputs (costs)) obtained using data envelopment analysis. Secondary outcomes are related to comorbidity control, outcome evolution and treatment costs. In addition, a bundled payment scheme will be determined as well as potential improvements in the treatment process. A total of 350 patients will be included in this trial and the study initiation is foreseen on 1 March 2023.

ETHICS AND DISSEMINATION

This study has been approved by the Ethics Committee of the Ghent University Hospital. The findings of this study will be disseminated by various means: (1) publication in one or more peer-reviewed dermatology and/or management journals, (2) (inter)national congresses, (3) via the psoriasis patient community and (4) through the research team's social media channels.

TRIAL REGISTRATION NUMBER

NCT05480917.

摘要

简介

目前,医疗保健行业面临巨大的财政压力,许多人认为,当前的体系不可持续,需要进行重大变革。此外,所提供的护理质量差异很大。已经提出了几种解决方案,其中概念框架称为基于价值的医疗保健(VBHC)在本研究中进一步探讨了银屑病。银屑病是一种慢性炎症性皮肤病,与高疾病负担和高治疗成本相关。本研究的目的是调查 VBHC 框架用于管理银屑病的可行性。

方法和分析

这是一项前瞻性临床研究,将对根特大学医院银屑病诊所(PsoPlus)新就诊的患者进行为期 1 年的随访。主要结果是确定为银屑病患者创造的价值。所创造的价值将被视为使用数据包络分析获得的价值评分(即加权产出(结果)除以加权投入(成本))演变的反映。次要结果与合并症控制、结果演变和治疗成本有关。此外,还将确定一揽子支付计划以及治疗过程的潜在改进。该试验将纳入 350 名患者,预计于 2023 年 3 月 1 日开始研究。

伦理和传播

本研究已获得根特大学医院伦理委员会的批准。该研究的结果将通过多种方式传播:(1)在一份或多份同行评议的皮肤病学和/或管理期刊上发表,(2)(国际)大会,(3)通过银屑病患者社区,(4)通过研究团队的社交媒体渠道。

试验注册号

NCT05480917。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5834/10230887/91eb3ca4ad32/bmjopen-2022-067504f01.jpg

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