Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Neurology, University Medicine Greifswald, Greifswald, Germany.
BMC Health Serv Res. 2023 Sep 22;23(1):1021. doi: 10.1186/s12913-023-09985-5.
A significant and growing portion of the global burden of diseases is caused by neurological disorders. Tele-neurology has the potential to improve access to health care services and the quality of care, particularly in rural and underserved areas. The economic evaluation of the stepped wedge randomised controlled trial NeTKoH aims to ascertain the cost-effectiveness and cost-utility regarding the effects of a tele-neurologic intervention in primary care in a rural area in Germany.
This protocol outlines the methods used when conducting the trial-based economic evaluation of NeTKoH. The outcomes used in our economic analysis are all prespecified endpoints of the NeTKoH trial. Outcomes considered for the cost-utility and cost-effectiveness analyses will be quality-adjusted life years (QALYs) derived from the EQ-5D-5L, proportion of neurologic problems being solved at the GP's office (primary outcome), hospital length-of-stay and number of hospital stays. Costs will be prospectively collected during the trial by the participating statutory health insurances, and will be analysed from a statutory health insurance perspective within the German health care system. This economic evaluation will be reported complying with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.
This within-trial economic evaluation relaying the costs and outcomes of an interdisciplinary tele-consulting intervention will provide high-quality evidence for cost-effectiveness and policy implications of a tele-neurological programme, including the potential for application in other rural areas in Germany or other jurisdictions with a comparable health system.
German Clinical Trials Register (DRKS00024492), date registered: September 28, 2021.
神经紊乱导致的疾病在全球疾病负担中占很大比例,且这一比例还在不断增长。远程神经医学有可能改善医疗服务的可及性和医疗质量,尤其是在农村和服务不足的地区。NeTKoH 阶梯式随机对照试验的经济评价旨在确定德国农村地区初级保健中远程神经干预的效果的成本效益和成本效用。
本方案概述了在 NeTKoH 中进行基于试验的经济评价所使用的方法。我们经济分析中使用的结果均为 NeTKoH 试验的预设终点。将用于成本效用和成本效果分析的结果是从 EQ-5D-5L 中得出的质量调整生命年(QALY)、在全科医生办公室解决的神经问题比例(主要结果)、住院时间和住院次数。在试验期间,参与的法定健康保险将前瞻性地收集成本,并将从德国卫生保健系统中的法定健康保险角度进行分析。该经济评价将按照统一健康经济评价报告标准(CHEERS)清单进行报告。
该基于试验的经济评价对跨学科远程咨询干预的成本和结果进行评估,将为远程神经学计划的成本效益和政策影响提供高质量证据,包括在德国其他农村地区或具有类似卫生系统的其他司法管辖区应用的潜力。
德国临床试验注册处(DRKS00024492),注册日期:2021 年 9 月 28 日。