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如何评估健康收益。

How to Assess Health Gains.

作者信息

Guarducci Giovanni, Messina Gabriele, Siragusa Chiara, Gurnari Jolanda, Gentile Anna Maria, Nante Nicola

机构信息

Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy.

Local Health Authority of Ferrara, 44121 Ferrara, Italy.

出版信息

Healthcare (Basel). 2025 Apr 5;13(7):832. doi: 10.3390/healthcare13070832.

Abstract

: As life expectancy rises and the epidemiological landscape of chronic diseases evolves, the necessity to assess and improve the overall health status of the population becomes increasingly fundamental. Therefore, evaluating health gains is a crucial challenge for modern health systems, particularly in the context of limited resources and increasing demand for services. The aim of this study is to assess health gains and their costs, with data provided by a private Italian clinic. : We conducted a retrospective study on 129 patients admitted between June 2020 and August 2023 in a solvent ward for short-term planned hospitalization. The patients completed the EQ-5D-5L questionnaire at both admission and discharge. Quality-Adjusted Life Years (QALYs) were estimated based on the difference in EQ-5D-5L scores between discharge and admission, assuming that health gains persist up to two years post-discharge. Through QALYs value and hospitalization cost, a cost-utility analysis was performed. Descriptive and statistical analyses were carried out using STATA SE/14.0 software. : Of the studied sample, 55% was female, the median age was 81 [11] years old, and the median length of stay (LoS) was 16 [16] days. The patients gained, in median, 0.33 [0.38] in QALY, which was higher for males (0.35 [0.34]) than females (0.29 [0.45]). The QALY gained was greater for the non-geriatric patients (0.41 [0.42]) than geriatric ones (0.32 [0.38]) ( > 0.05). Those with a longer LoS showed a higher gain in QALY (0.35 [0.42]) than those with a shorter one (0.23 [0.29]) ( < 0.05). The cost per QALY gained was, in median, EUR 14,337, which was lower in males (EUR 13,803), in non-geriatric patients (EUR 13,743), and in patients with a shorter LoS (EUR 10,670) ( > 0.05). : Although QALY gains differed among the groups, the median cost per QALY remained consistent. These results highlight the need for targeted interventions to optimize resource allocation, both by integrating data into allocation strategies and by employing a multidisciplinary approach to tailor interventions.

摘要

随着预期寿命的延长以及慢性病流行病学格局的演变,评估和改善人群整体健康状况的必要性变得越来越重要。因此,评估健康收益是现代卫生系统面临的一项关键挑战,尤其是在资源有限且服务需求不断增加的背景下。本研究的目的是利用一家意大利私立诊所提供的数据,评估健康收益及其成本。

我们对2020年6月至2023年8月期间在一个有偿病房接受短期计划住院治疗的129名患者进行了回顾性研究。患者在入院和出院时均完成了EQ-5D-5L问卷。基于出院和入院时EQ-5D-5L评分的差异估算质量调整生命年(QALYs),假设健康收益可持续至出院后两年。通过QALYs值和住院费用,进行了成本效用分析。使用STATA SE/14.0软件进行描述性和统计分析。

在研究样本中,55%为女性,中位年龄为81[11]岁,中位住院时间(LoS)为16[16]天。患者的QALY中位数增加了0.33[0.38],男性(0.35[0.34])高于女性(0.29[0.45])。非老年患者(0.41[0.42])获得的QALY高于老年患者(0.32[0.38])(>0.05)。住院时间较长的患者QALY增加幅度(0.35[0.42])高于住院时间较短的患者(0.23[0.29])(<0.05)。每获得一个QALY的成本中位数为14337欧元,男性(13803欧元)、非老年患者(13743欧元)和住院时间较短的患者(10670欧元)的成本较低(>0.05)。

尽管各组之间的QALY增加有所不同,但每QALY的成本中位数保持一致。这些结果凸显了采取针对性干预措施以优化资源分配的必要性,既可以将数据纳入分配策略,也可以采用多学科方法来定制干预措施。

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