Modeling the Cost Savings of Continuous Pulse Oximetry and Capnography Monitoring of United States General Care Floor Patients Receiving Opioids Based on the PRODIGY Trial.
Modeling the Cost Savings of Continuous Pulse Oximetry and Capnography Monitoring of United States General Care Floor Patients Receiving Opioids Based on the PRODIGY Trial.
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DOI：
10.1007/s12325-021-01779-7
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发表时间：
2021-07
影响因子：
3.8
通讯作者：
PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) Group Investigators
中科院分区：
文献类型：
--
作者：
Khanna AK;Jungquist CR;Buhre W;Soto R;Di Piazza F;Saager L;PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) Group Investigators
尽管普通护理楼层呼吸抑制的发生率较高，并且有证据表明连续监测可改善患者结局，但普通护理楼层患者连续脉搏血氧饱和度和二氧化碳监测的成本效益仍未知。本研究模拟了有呼吸抑制风险的普通护理楼层患者的持续脉搏血氧饱和度和二氧化碳监测的成本和住院时间节省、投资盈亏平衡点以及成本节省的可能性。创建决策树模型，以比较间歇性脉搏血氧饱和度与连续性脉搏血氧饱和度和二氧化碳监测。该模型利用了通过capnoGraphY（PRODIGY）试验监测的患者中阿片类药物诱导的呼吸抑制预测的成本和结果，并应用于美国中型普通护理楼层每年接受阿片类药物的2447名患者的建模队列。对高危患者进行连续脉搏血氧饱和度和二氧化碳监测预计将使年度住院费用减少535，531美元，并使患者累计住院时间减少103天。呼吸抑制减少1.5%将达到收支平衡的投资点，并证明投资成本是合理的。如果呼吸抑制降低≥ 17%，则成本节约的概率≥ 80%。将连续监测扩展至高风险和中风险患者或所有患者，预计当呼吸抑制分别降低2.5%和3.5%时达到盈亏平衡点，当呼吸抑制分别降低≥ 27%和≥ 31%时，成本节约的概率≥ 80%。与间歇性脉搏血氧仪相比，接受阿片类药物的普通护理楼层患者的连续脉搏血氧仪和二氧化碳监测具有很高的成本效益。www.clinicaltrials.gov，注册ID：NCT 02811302。在线版本包含补充材料，可通过10.1007/s12325-021-01779-7获得。
Despite the high incidence of respiratory depression on the general care floor and evidence that continuous monitoring improves patient outcomes, the cost–benefit of continuous pulse oximetry and capnography monitoring of general care floor patients remains unknown. This study modeled the cost and length of stay savings, investment break-even point, and likelihood of cost savings for continuous pulse oximetry and capnography monitoring of general care floor patients at risk for respiratory depression. A decision tree model was created to compare intermittent pulse oximetry versus continuous pulse oximetry and capnography monitoring. The model utilized costs and outcomes from the PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) trial, and was applied to a modeled cohort of 2447 patients receiving opioids per median-sized United States general care floor annually. Continuous pulse oximetry and capnography monitoring of high-risk patients is projected to reduce annual hospital cost by $535,531 and cumulative patient length of stay by 103 days. A 1.5% reduction in respiratory depression would achieve a break-even investment point and justify the investment cost. The probability of cost saving is ≥ 80% if respiratory depression is decreased by ≥ 17%. Expansion of continuous monitoring to high- and intermediate-risk patients, or to all patients, is projected to reach a break-even point when respiratory depression is reduced by 2.5% and 3.5%, respectively, with a ≥ 80% probability of cost savings when respiratory depression decreases by ≥ 27% and ≥ 31%, respectively. Compared to intermittent pulse oximetry, continuous pulse oximetry and capnography monitoring of general care floor patients receiving opioids has a high chance of being cost-effective. www.clinicaltrials.gov, Registration ID: NCT02811302. The online version contains supplementary material available at 10.1007/s12325-021-01779-7.
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影响因子：
7.4
作者：
Cozowicz, Crispiana;Olson, Ashley;Memtsoudis, Stavros G.
通讯作者：
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影响因子：
8.8
作者：
Lee, Lorri A.;Caplan, Robert A.;Domino, Karen B.
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影响因子：
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作者：
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影响因子：
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作者：
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Polomano, Rosemary C.
DOI：
10.3109/15360288.2014.938889
发表时间：
2014-09-01
影响因子：
1.1
作者：
Kane-Gill, Sandra L;Rubin, Ellen C;Dasta, Joseph F
通讯作者：
Dasta, Joseph F