Langenberger Benedikt, Siegel Martin, Busse Reinhard, Vogt Verena
Technical University of Berlin, Berlin, Germany.
Hasso Plattner Institute, Potsdam, Germany.
BMC Health Serv Res. 2025 May 30;25(1):773. doi: 10.1186/s12913-025-12898-0.
The high prevalence of multimorbidity in the aging population necessitates complex medication regimens, increasing the risk of adverse drug events (ADEs) and hospital admissions. This paper evaluates an intervention aimed at improving medication safety for northeastern and western Germany under real-world conditions, thereby providing a pragmatic approach to the challenges of multi-center studies with staggered intervention starts and voluntary participation. The analysis utilizes iterative Propensity Score Matching (PSM) followed by a Difference-in-Differences (DiD) estimator to navigate the methodological complexities and assess the intervention's effectiveness and cost-effectiveness. Results reveal a significant reduction in ADE-related hospital admissions by 27.5% and overall hospital admissions by 17.5%. We find that the intervention is cost-effective at an incremental cost-effectiveness ratio (ICER) of €15,169.66 per averted ADE and €4,180.61 per averted hospital admission. This study illustrates for evaluating complex health interventions in real-world settings and underscores the importance of balancing health outcomes improvements with economic considerations in aging populations.
老年人群中多重疾病的高患病率使得药物治疗方案变得复杂，增加了药物不良事件（ADEs）和住院的风险。本文评估了一项旨在在现实世界条件下提高德国东北部和西部用药安全性的干预措施，从而为多中心研究中交错启动干预和自愿参与所带来的挑战提供一种务实的方法。该分析采用迭代倾向得分匹配（PSM），随后使用差分法（DiD）估计量来应对方法上的复杂性，并评估干预措施的有效性和成本效益。结果显示，与ADE相关的住院人数显著减少了27.5%，总体住院人数减少了17.5%。我们发现，该干预措施具有成本效益，每避免一次ADE的增量成本效益比（ICER）为15,169.66欧元，每避免一次住院的ICER为4,180.61欧元。这项研究说明了在现实世界环境中评估复杂健康干预措施的情况，并强调了在老年人群中平衡健康结果改善与经济考虑因素的重要性。
