Vidigal Maria Tereza Campos, Borges Guilherme Henrique, Rabelo Diogo Henrique, de Andrade Vieira Walbert, Nascimento Gustavo G, Lima Rafael Rodrigues, Costa Márcio Magno, Herval Álex Moreira, Paranhos Luiz Renato
Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
Department of Dentistry, Centro Universitario das Faculdades Associadas de Ensino, São João da Boa Vista, SP, Brazil.
Front Med (Lausanne). 2024 Oct 3;11:1405840. doi: 10.3389/fmed.2024.1405840. eCollection 2024.
To compare, through a systematic literature review, the cost-effectiveness ratio of home care compared to hospital care for following up patients with chronic obstructive pulmonary disease (COPD).
This review was registered in PROSPERO, and the bibliographic search was performed in six primary databases [MedLine (via PubMed), Scopus, LILACS, SciELO, Web of Science, and Embase], two dedicated databases for economic studies (NHS Economic Evaluation Database (NHS EED) and Cost-Effectiveness Analysis (CEA) Registry), and two databases for partially searching the "gray literature" (DansEasy and ProQuest). This review only included studies that compared home and hospital care for patients diagnosed with COPD, regardless of publication year or language. Two reviewers selected the studies, extracted the data, and assessed the risk of bias independently. A JBI tool was used for risk of bias assessment.
7,279 studies were found, of which 14 met the eligibility criteria. Only one study adequately met all items of the risk of bias assessment. Thirteen studies found lower costs and higher effectiveness for home care. Home care showed a better cost-effectiveness ratio than hospital care for COPD patients. Regarding effectiveness, there is no possibility of choosing a more effective care for COPD patients, given the incipience of the data presented on eligible studies. However, considering the analyzed data refer only to high-income countries, caution is required when extrapolating this conclusion to low- and low-middle-income countries.
https://www.crd.york.ac.uk/prospero/, identifier CRD42022319488.
通过系统的文献综述，比较慢性阻塞性肺疾病（COPD）患者居家护理与医院护理的成本效益比。
本综述已在国际前瞻性系统评价注册库（PROSPERO）登记，在六个主要数据库[医学期刊数据库（通过PubMed）、Scopus、拉丁美洲及加勒比地区卫生科学数据库（LILACS）、科学电子图书馆在线（SciELO）、科学引文索引扩展版（Web of Science）和荷兰医学文摘数据库（Embase）]、两个经济研究专用数据库[英国国家卫生服务系统经济评价数据库（NHS EED）和成本效益分析（CEA）注册库]以及两个用于部分检索“灰色文献”的数据库（DansEasy和ProQuest）中进行文献检索。本综述仅纳入比较COPD确诊患者居家护理与医院护理的研究，不考虑出版年份或语言。两名评审员独立选择研究、提取数据并评估偏倚风险。使用循证卫生保健中心（JBI）工具进行偏倚风险评估。
共检索到7279项研究，其中14项符合纳入标准。只有一项研究完全符合偏倚风险评估的所有项目。13项研究发现居家护理成本更低且效果更好。对于COPD患者，居家护理的成本效益比优于医院护理。关于效果，鉴于纳入研究中提供的数据有限，无法为COPD患者选择更有效的护理方式。然而，考虑到所分析的数据仅来自高收入国家，将这一结论外推至低收入和中低收入国家时需谨慎。
