An economic evaluation of the healthcare cost of tinnitus management in the UK.
An economic evaluation of the healthcare cost of tinnitus management in the UK.
复制标题
对英国耳鸣管理的医疗费用的经济评估。
DOI：
10.1186/s12913-017-2527-2
复制
发表时间：
2017-08-22
影响因子：
2.8
通讯作者：
Hoare DJ
中科院分区：
文献类型：
--
作者：
Stockdale D;McFerran D;Brazier P;Pritchard C;Kay T;Dowrick C;Hoare DJ
耳鸣的症状有哪些？耳鸣的症状有哪些？可能的治疗包括教育和安慰，认知行为疗法，改良的耳鸣再训练疗法（教育和声音丰富），或使用助听器放大外部声音。然而，大多数治疗方法的有效性是有争议的。随着卫生服务面临更有效地部署资源的经济压力，越来越需要证明耳鸣治疗的价值，以及如何不断提高价值。该项目的目的是绘制出现有的临床实践，估计NHS的成本与管理方法的使用，并获得成本效益的初步指示性估计。目前的治疗途径，成本和健康结果是从耳鸣文献，国家统计数据，患者调查和专家意见中确定的。这些被用来创建一个基于Excel的耳鸣患者治疗选择的经济模型。与个体患者接受特定组合治疗的可能性相关的概率用于计算每例患者的平均治疗成本、以QALY获得的QALY测量的每例患者的平均健康结果以及以每QALY获得的平均成本测量的成本效益。每位患者每年耳鸣治疗的平均费用为GB£717，相当于每年GB£ 7.5亿的NHS医疗保健账单。在所有途径中，耳鸣治疗每获得QALY花费10，600英镑。结果是相对不敏感的限制获得认知行为疗法，并随后依赖于其他疗法。NHS规定耳鸣是符合成本效益的对国家健康和护理卓越研究所的成本效益阈值。大多数干预措施都有帮助，但教育本身带来的QALY收益非常小。模型中最具成本效益的治疗是在听力学中提供的。本文的在线版本（doi：10.1186/s12913-017-2527-2）包含补充材料，可供授权用户使用。
There is no standard treatment pathway for tinnitus patients in the UK. Possible therapies include education and reassurance, cognitive behavioural therapies, modified tinnitus retraining therapy (education and sound enrichment), or amplification of external sound using hearing aids. However, the effectiveness of most therapies is somewhat controversial. As health services come under economic pressure to deploy resources more effectively there is an increasing need to demonstrate the value of tinnitus therapies, and how value may be continuously enhanced. The objective of this project was to map out existing clinical practice, estimate the NHS costs associated with the management approaches used, and obtain initial indicative estimates of cost-effectiveness. Current treatment pathways, costs and health outcomes were determined from the tinnitus literature, national statistics, a patient survey, and expert opinion. These were used to create an Excel-based economic model of therapy options for tinnitus patients. The probabilities associated with the likelihood of an individual patient receiving a particular combination of therapies was used to calculate the average cost of treatment per patient, average health outcome per patient measured in QALYs gained, and cost-effectiveness, measured by the average cost per QALY gained. The average cost of tinnitus treatment per patient per year is GB£717, equating to an NHS healthcare bill of GB£750 million per year. Across all pathways, tinnitus therapy costs £10,600 per QALY gained. Results were relatively insensitive to restrictions on access to cognitive behaviour therapy, and a subsequent reliance on other therapies. NHS provisions for tinnitus are cost-effective against the National Institute for Health and Care Excellence cost-effective threshold. Most interventions help, but education alone offers very small QALY gains. The most cost-effective therapies in the model were delivered within audiology. The online version of this article (doi:10.1186/s12913-017-2527-2) contains supplementary material, which is available to authorized users.
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DOI：
10.1111/j.1365-2753.2011.01696.x
发表时间：
2011-08-01
影响因子：
2.4
作者：
El-Shunnar, Suliman K.;Hoare, Derek J.;Hall, Deborah A.
通讯作者：
Hall, Deborah A.
影响因子：
3
作者：
Feeny, D;Furlong, W;Boyle, M
通讯作者：
Boyle, M
影响因子：
3.7
作者：
Martinez, Carlos;Wallenhorst, Christopher;Hall, Deborah A.
通讯作者：
Hall, Deborah A.
影响因子：
2.1
作者：
Maes, Iris H. L.;Cima, Rilana F. F.;Joore, Manuela A.
通讯作者：
Joore, Manuela A.
影响因子：
2.8
作者：
Hall DA;Láinez MJ;Newman CW;Sanchez TG;Egler M;Tennigkeit F;Koch M;Langguth B
通讯作者：
Langguth B