Behaviour modification intervention for patients with chronic kidney disease could provide a mid- to long-term reduction in public health care expenditure: budget impact analysis
Behaviour modification intervention for patients with chronic kidney disease could provide a mid- to long-term reduction in public health care expenditure: budget impact analysis
复制标题
对慢性肾病患者的行为矫正干预可以提供中长期的公共医疗保健支出减少：预算影响分析
DOI：
10.1007/s10157-022-02185-1
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发表时间：
2022
影响因子：
2.3
通讯作者：
Yamagata Kunihiro
中科院分区：
文献类型：
--
作者：
Okubo Reiko;Kondo Masahide;Hoshi Shu-Ling;Kai Hirayasu;Saito Chie;Iseki Kunitoshi;Iseki Chiho;Watanabe Tsuyoshi;Narita Ichiei;Matsuo Seiichi;Makino Hirofumi;Hishida Akira;Yamagata Kunihiro
最近的一项成本效益分析（CEA）研究评估了慢性肾脏病（CKD）患者行为矫正干预的广泛普及。将这种行为改变干预措施（包括营养/生活方式教育课程和定期患者访视支持）推广到当前基于CKD指南的实践中被认为具有成本效益。本研究的目的是研究这种有效的新做法的假设下，行为矫正干预将启动由普通医师（GPs.MethodsA预算影响分析进行了定义的目标人群为40-74岁的患者阶段-3-5 CKD的基础上，在日本一般人群中的患病率确定的CKD。社会保险公司在没有折扣的情况下支出的费用被计为预算。我们估计，每年的预算影响15年，通过运行我们的CEA模型，假设它将是好的span.ResultsWe估计终末期肾病（ESKD）的患者人数减少4,496在第十五年的新做法，使用我们的CEA模型。相比，在目前的做法，预算的影响，新的做法的总额外支出估计是负面的第十年在basecase.ConclusionsThe广泛传播的行为矫正干预将包含公共卫生保健支出在中长期，减少进展ESKD。我们建议，提供足够的经济激励，全科医生和加强CKD指南中的建议将实现有效的GP发起的干预措施。
BackgroundA recent cost-effectiveness analysis (CEA) study evaluated the widespread diffusion of behaviour modification intervention for patients with chronic kidney disease (CKD). Incorporating this behaviour modification intervention, comprising educational sessions on nutrition/lifestyle and support for regular patient visits, to the current CKD guideline-based practice was found to be cost-effective. This study aimed to examine the affordability of this efficient new practice under the hypothesis that the behaviour modification intervention would be initiated by general physicians (GPs).MethodsA budget impact analysis was conducted by defining the target population as patients aged 40–74 years with stage-3–5 CKD based on the prevalence of definitive CKD in the Japanese general population. Costs expended by social insurers without discount were counted as budgets. We estimated the annual budget impact for 15 years by running our CEA model, assuming that it would be good for the span.ResultsWe estimated the number of patients with end-stage kidney disease (ESKD) to decrease by 4,496 in the fifteenth year of the new practice using our CEA model. Compared to that in the current practice, the budget impact as total additional expenditure of the new practice was estimated to be negative by the tenth year in the base case.ConclusionsThe widespread diffusion of behaviour modification intervention would contain public health care expenditure over the mid-to-long term, resulting from a reduction in progression to ESKD. We suggest that providing sufficient economic incentives to GPs and strengthening recommendations in CKD guidelines would realise effective GP-initiated interventions.
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影响因子：
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作者：
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DOI：
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发表时间：
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期刊：
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影响因子：
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作者：
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影响因子：
0.7
作者：
J. Mauskopf;S. Earnshaw;A. Brogan;Ph.D. Sorrel Wolowacz;T. Brodtkorb
通讯作者：
T. Brodtkorb