Nakane Eisaku, Kato Takao, Tanaka Nozomi, Idouji Makoto, Yamamoto Yuki, Saitou Wataru, Hamaguchi Toka, Yano Mariko, Harita Takeshi, Yamaji Yuhei, Fukuda Hiroki, Haruna Tetsuya, Inoko Moriaki
Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.
Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine Kyoto Japan.
Circ Rep. 2024 Dec 7;7(1):31-36. doi: 10.1253/circrep.CR-24-0088. eCollection 2025 Jan 10.
We recently reported that the self-care management system for heart failure (HF) decreased re-hospitalization for HF. In the present study we estimate the cost-effectiveness of this system.
We retrospectively enrolled 569 consecutive patients who were admitted for HF treatment at Kitano Hospital. In the present analysis, we sought to compare cardiovascular healthcare costs and the incremental cost-effective ratio (ICER), expressed as the cost per quality-adjusted life-years (QALY) gained, between patients using the self-care management system (n=153) and those not using the system (n=153) after propensity-score matching. To calculate the QALY, we used the New York Heart Association class and the corresponding scores of quality of life in every 3 months. The healthcare costs of cardiovascular disease were ¥129,747,016 in the user group and ¥156,427,032 in the non-user group, where 24 and 43 patients were hospitalized, respectively. The cost of this new system was ¥50,000 in the user group. The total costs were ¥129,797,016 in the user group and ¥156,427,032 in the non-user group. By using the system, the QALY increased from 0.653 to 0.686. The ICER was below 0 and the system was interpreted as cost-effective.
Use of the self-care management system is likely to be a cost-effective treatment for HF with the increase in QALY and the decrease in healthcare costs.
我们最近报告称，心力衰竭（HF）自我护理管理系统降低了HF的再住院率。在本研究中，我们评估了该系统的成本效益。
我们回顾性纳入了569例在北野医院因HF治疗入院的连续患者。在本分析中，我们试图比较倾向得分匹配后使用自我护理管理系统的患者（n = 153）和未使用该系统的患者（n = 153）之间的心血管医疗保健成本以及增量成本效益比（ICER），以每获得的质量调整生命年（QALY）的成本来表示。为了计算QALY，我们使用纽约心脏协会分级以及每3个月相应的生活质量评分。用户组心血管疾病的医疗保健成本为129747016日元，非用户组为156427032日元，两组分别有24例和43例患者住院。用户组中该新系统的成本为50000日元。用户组的总成本为129797016日元，非用户组为156427032日元。通过使用该系统，QALY从0.653提高到0.686。ICER低于0，该系统被认为具有成本效益。
使用自我护理管理系统可能是一种对HF具有成本效益的治疗方法，可提高QALY并降低医疗保健成本。
