Dynamic modeling in medical technology assessment - Fitting hearing aids in the Netherlands
Dynamic modeling in medical technology assessment - Fitting hearing aids in the Netherlands
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DOI：
10.1017/s0266462301107178
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发表时间：
2001-09-01
影响因子：
3.2
通讯作者：
Anteunis, L
中科院分区：
文献类型：
--
作者：
Boas, G;van der Stel, H;Anteunis, L
目的：本文的主要目的是证明动态建模对医疗保健技术经济评估的有用性。具体来说，这一方法用于评估助听器在荷兰卫生保健中的使用影响。方法：将人群分为不同的健康等级，随着时间的推移，这些等级之间会发生转变。转移概率是由外生数据导出的。这些转变与经济和社会成本和效益有关。对助听器满意的人会得到好处。这些益处用质量调整生命年（QALYs）来表示。成本是在过渡期间产生的（主要是助听器的安装）。从一个特定年龄组的人开始，进行了队列分析。研究的起点是这个年龄段的固定数量的人，他们一生都在被跟踪。结果：计算了两个卫生项目的每质量质量比成本。验配助听器项目描述了荷兰的现状；购买后助听器咨询计划是对第一个计划的假设补充，其中基于荷兰研究的干预措施是为了提高助听器的满意度。未来收益和成本按5%折现。结论：动态建模方法比静态建模方法提供了更真实的图像。特别是，验配助听器计划的成本效益与售后咨询助听器计划进行了比较。
Objectives: The main objective of this article is to demonstrate the usefulness of dynamic modeling for an economic assessment of technology in health care. Specifically, this approach is applied to assess the impact of the use of hearing aids in Dutch health care.Methods: The population is divided into different health classes between which, over time, transitions occur. Transition probabilities are derived from exogenous data. The transitions are associated with economic and societal costs and benefits. People who are satisfied with their hearing aids experience benefits. These benefits are expressed by quality-adjusted life-years (QALYs). Costs are made during transitions (mainly the fitting of hearing aids). A cohort analysis is carried out, starting with people in a particular age group. The starting point is a fixed number of people within this age group, who are followed during their whole lifetime.Results: Costs per QALY ratios are calculated for two health programs. The Fitting Hearing Aid Program describes the present situation in the Netherlands; the Post-purchase Counseling Hearing Aid Program is a hypothetical addition to the first program, where an intervention based on a Dutch study is undertaken to improve satisfaction with hearing aids. Future benefits and costs are discounted at a rate of 5%.Conclusions: The dynamic modeling approach provides a more realistic picture than a static approach. Particularly, the cost-effectiveness of the Fitting Hearing Aid Program is compared with the Post-purchase Counseling Hearing Aid Program.