The cost-effectiveness of hearing-aid fitting in the Netherlands
The cost-effectiveness of hearing-aid fitting in the Netherlands
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DOI：
10.1001/archotol.129.3.297
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发表时间：
2003-03-01
影响因子：
--
通讯作者：
Anteunis, JC
中科院分区：
文献类型：
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作者：
Joore, MA;van der Stel, H;Anteunis, JC
目的：确定助听器验配的成本效益。设计：基于汇总数据和前瞻性干预研究结果，使用马尔可夫模型进行成本效益分析。背景：成本效益研究以普通社区为基础。这项前瞻性研究是以医院为基础的，因为 85% 的首次助听器使用者在助听器验配过程中会到医院就诊。患者：前瞻性干预研究包括没有助听器使用禁忌症的成人首次助听器使用者。干预：荷兰助听器验配的通常过程。主要结果指标：每个质量调整生命年 (QALY) 的成本。 QALY 基于 EuroQol 分数。我们在分析中纳入了直接和间接成本。 结果：EuroQol 测量的平均改善为 0.03（95% 置信区间 [C1]，-0.03 至 0.08），听力特定视觉模拟量表的平均改善为 0.27（95% CI，0.22-0.31）。基于 EuroQol 的基本案例结果为 615807/QALY（17072 美元/QALY）（CI，-1624239/QALY 至 163718/QALY）。结论：根据该基本案例估计，验配助听器被认为是一种具有成本效益的医疗保健干预措施。 Cl 表明结果并非明确阳性，可能是因为 EuroQol 对助听器验配评估缺乏敏感性。到目前为止，还没有研究发现助听器验配对一般生活质量有影响。因此，需要采取适合评估感觉障碍干预措施（例如助听器验配）对一般生活质量的影响的措施。
Objective: To determine the cost-effectiveness of hearing-aid fitting.Design: Cost-effectiveness analysis using a Markov model based on aggregate data and results from a prospective intervention study.Setting: The cost-effectiveness study was based in the general community. The prospective study was hospital based, as 85% of the first-time hearing-aid users attend a hospital in the process of hearing-aid fitting.Patients: The prospective intervention study included adult first-time hearing-aid users with no contraindications for hearing-aid use.Intervention: The usual process of hearing-aid fitting in the Netherlands.Main Outcome Measure: Costs per quality-adjusted life-year (QALY). The QALYs were based on EuroQol scores. We included direct and indirect costs in the analysis.Results: The mean improvement on the EuroQol measure was 0.03 (95% confidence interval [C1], -0.03 to 0.08), and on the hearing-specific visual analog scale, 0.27 (95% CI, 0.22-0.31). The base-case outcome based on the EuroQol was 615807/QALY (US $17072/QALY) (CI, -1624239/QALY to 163718/QALY).Conclusions: On the basis of this base-case estimate, fitting of hearing aids is considered a cost-effective health care intervention. The Cl indicates that the result is not unambiguously positive, probably because the EuroQol lacked sensitivity for the evaluation of hearing-aid fitting. Until now, no study has found an effect of hearing-aid fitting on generic quality of life. Therefore, measures are needed that are suitable for the evaluation of the effects of interventions for sensory disabilities, such as the fitting of hearing aids, on generic quality of life.