The costs and benefits of bowel cancer service developments using discrete event simulation
The costs and benefits of bowel cancer service developments using discrete event simulation
复制标题
使用离散事件模拟开发肠癌服务的成本和收益
DOI：
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发表时间：
2009
影响因子：
3.6
通讯作者：
J. Tappenden
中科院分区：
文献类型：
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作者：
H. Pilgrim;P. Tappenden;J. Chilcott;M. Bending;P. Trueman;A. Shorthouse;J. Tappenden
结直肠癌包括结肠、直肠和阑尾中的癌性生长，每年在英国影响约3万人。最大限度地提高结直肠癌患者的健康效益需要考虑整个服务的成本和结果。在医疗资源稀缺的时代，不仅需要考虑技术和服务是否在临床上有效，而且还需要考虑它们是否具有成本效益，即它们是否代表医疗服务的资金价值。通过开发一个整体疾病模型，有可能在一个共同框架内对一系列服务发展备选方案的成本效益进行一致评价。离散事件模拟已被用于模拟完整的结直肠癌患者路径，从患者就诊到转诊和诊断、治疗、随访、潜在复发、转移治疗和临终关怀。该模拟模型已被用于检查整个结直肠癌途径中不同改变选择的潜在成本效益。本文提供了一个实证示范的潜在应用建模整个疾病领域，告知临床政策和资源分配决策。
Colorectal cancer includes cancerous growths in the colon, rectum and appendix and affects around 30 000 people in England each year. Maximizing health benefits for patients with colorectal cancer requires consideration of costs and outcomes across the whole service. In an era of scarce healthcare resources, there is a need to consider not only whether technologies and services may be considered clinically effective, but also whether they are cost-effective, that is, whether they represent value for money for the health service. Through the development of a whole disease model, it is possible to evaluate the cost-effectiveness of a range of options for service development consistently within a common framework. Discrete event simulation has been used to model the complete colorectal cancer patient pathway from patient presentation through to referral and diagnosis, treatment, follow-up, potential recurrence, treatment of metastases and end-of-life care. This simulation model has been used to examine the potential cost-effectiveness of different options for change across the entire colorectal cancer pathway. This paper provides an empirical demonstration of the potential application of modelling entire disease areas to inform clinical policy and resource allocation decision-making.