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使用基于办公室的即时检验（RED）优化普通胃肠病学中慢性便秘的成本效益护理：成本效益和成本最小化分析。

Optimizing Cost-Effective Care for Chronic Constipation in General Gastroenterology Using an Office-Based, Point-Of-Care Test (RED): Cost-Effectiveness and Cost-Minimization Analysis.

作者信息

Shah Eric D, Chey William D

机构信息

Michigan Medicine, Ann Arbor, Michigan, USA.

出版信息

Am J Gastroenterol. 2024 Dec 1;119(12):2529-2531. doi: 10.14309/ajg.0000000000002989. Epub 2024 Jul 26.

DOI:10.14309/ajg.0000000000002989
PMID:39167526
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11617264/
Abstract

INTRODUCTION

We aimed to evaluate the cost-effectiveness/cost-savings of point-of-care anorectal function testing with an investigational device (RED) to triage therapy for chronic constipation in general gastroenterology.

METHODS

A Markov model was constructed to evaluate cost-effectiveness/cost-savings over a 1-year time horizon comparing empiric drug/pelvic floor physical therapy to testing guided care.

RESULTS

RED appears to inform the cost-effective strategy for chronic constipation. Compared with usual care without RED, it reduces insurer costs by $810 and patient costs by $6,903.

DISCUSSION

Point-of-care testing using RED appears cost-effective/cost-saving to triage chronic constipation care in general gastroenterology.

摘要

引言

我们旨在评估使用一种研究性设备（RED）进行即时性肛门直肠功能测试，以对普通胃肠病学中慢性便秘的治疗进行分诊的成本效益/成本节约情况。

方法

构建了一个马尔可夫模型，以评估在1年时间范围内将经验性药物/盆底物理治疗与测试指导护理进行比较的成本效益/成本节约情况。

结果

RED似乎为慢性便秘的成本效益策略提供了依据。与不使用RED的常规护理相比，它可使保险公司成本降低810美元，患者成本降低6903美元。

讨论

在普通胃肠病学中，使用RED进行即时性测试似乎对慢性便秘护理分诊具有成本效益/成本节约作用。

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本文引用的文献

1
Optimizing the Management Algorithm for Adults With Functional Constipation Failing a Fiber/Laxative Trial in General Gastroenterology: Cost-Effectiveness and Cost-Minimization Analysis.在普通胃肠病学中，对纤维/泻药治疗失败的功能性便秘成人进行管理算法的优化：成本效益和成本最小化分析。
Am J Gastroenterol. 2024 Feb 1;119(2):342-352. doi: 10.14309/ajg.0000000000002515. Epub 2023 Oct 9.
2
Empiric Pelvic Rehabilitation Delivered by Pelvic Floor Physical Therapists as an Up-Front Treatment for Chronic Constipation.由盆底物理治疗师提供的经验性盆腔康复作为慢性便秘的前期治疗方法
Clin Gastroenterol Hepatol. 2023 Aug;21(9):2415-2417. doi: 10.1016/j.cgh.2022.07.023. Epub 2022 Aug 4.
3
Utility of Anorectal Testing to Predict Outcomes With Pelvic Floor Physical Therapy in Chronic Constipation: Pragmatic Trial.肛肠测试对预测慢性便秘患者盆底物理治疗效果的实用性：一项实用性试验
Clin Gastroenterol Hepatol. 2023 Apr;21(4):1070-1081. doi: 10.1016/j.cgh.2022.05.014. Epub 2022 May 29.
4
An Office-Based, Point-of-Care Test Predicts Treatment Outcomes With Community-Based Pelvic Floor Physical Therapy in Patients With Chronic Constipation.基于办公室的即时检测预测了社区盆底物理治疗对慢性便秘患者的治疗效果。
Clin Gastroenterol Hepatol. 2023 Apr;21(4):1082-1090. doi: 10.1016/j.cgh.2022.03.022. Epub 2022 Mar 24.
5
Development of a Simple, Point-of-Care Device to Test Anorectal Function in Patients with Constipation: Randomized Clinical Trial.开发一种简单的即时检测设备，用于测试便秘患者的肛肠功能：随机临床试验。
Clin Gastroenterol Hepatol. 2023 Mar;21(3):832-834. doi: 10.1016/j.cgh.2021.11.034. Epub 2021 Dec 2.
6
Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2021.美国胃肠道、肝脏和胰腺疾病的负担和成本：2021 年更新。
Gastroenterology. 2022 Feb;162(2):621-644. doi: 10.1053/j.gastro.2021.10.017. Epub 2021 Oct 19.
7
Evaluating the Impact of Cost on the Treatment Algorithm for Chronic Idiopathic Constipation: Cost-Effectiveness Analysis.评价成本对慢性特发性便秘治疗方案的影响：成本效益分析。
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Am J Gastroenterol. 2020 Jun;115(6):895-905. doi: 10.14309/ajg.0000000000000614.
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Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine.《健康与医疗领域成本效益分析的实施、方法学实践和报告推荐：第二版》。
JAMA. 2016 Sep 13;316(10):1093-103. doi: 10.1001/jama.2016.12195.