Is shared care with annual hospital review better value for money than predominantly hospital-based care in patients with established stable rheumatoid arthritis?
Is shared care with annual hospital review better value for money than predominantly hospital-based care in patients with established stable rheumatoid arthritis?
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对于已确诊的稳定型类风湿性关节炎患者来说，每年医院检查的共享护理是否比主要以医院为基础的护理更划算？
DOI：
10.1136/ard.2006.061234
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发表时间：
2006
影响因子：
27.4
通讯作者：
D. Symmons
中科院分区：
文献类型：
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作者：
Linda Mary Davies;Emily Anne Fargher;K. Tricker;P. Dawes;D. Scott;D. Symmons
目的：评价共享护理(SCSC)和院内积极治疗(ATH)对已建立的类风湿关节炎(RA)患者进行症状控制的成本效益和成本效益可接受性。方法：经济数据收集在英国类风湿结局研究小组关于SCSC和ATH的随机对照试验中。使用了广泛的视角(英国国家卫生服务、社会支持服务和患者)。估算了每质量调整寿命年(QALY)的成本、净效益统计数据和成本效益可接受曲线。成本和结果折现为3.5%。敏感度分析测试了结果对分析假设的稳健性。结果：SCSC组和ATH组人均(SD)费用分别为GB 4540(4700)和GB 4440(4900)。3年人均(SD)QALY：SCSC组为1.67(0.56)，ATH组为1.60(0.60)。如果决策者准备支付⩾GB 2000以获得1 QALY，则SCSC可能在60-90%的情况下具有成本效益。结论：初步的经济学分析和敏感性分析表明，在60%-90%的病例中，SCSC可能比ATH更具成本效益。这一结果似乎对分析所需的假设是稳健的。这项研究是为数不多的随机对照试验之一，目的是收集详细的资源使用和健康状况数据，并估计已建立的类风湿关节炎的治疗成本和QALY。这项试验是使用EuroQol的最大的RA研究之一。
Objective: To assess the cost effectiveness and cost effectiveness acceptability of symptom control delivered by shared care (SCSC) and aggressive treatment delivered in hospital (ATH) for established rheumatoid arthritis (RA). Methods: Economic data were collected within the British Rheumatoid Outcome Study Group randomised controlled trial of SCSC and ATH. A broad perspective was used (UK National Health Service, social support services and patients). Cost per quality adjusted life year (QALY) gained, net benefit statistics and cost effectiveness acceptability curves were estimated. Costs and outcomes were discounted at 3.5%. Sensitivity analysis tested the robustness of the results to analytical assumptions. Results: The mean (SD) cost per person was £4540 (4700) in the SCSC group and £4440 (4900) in the ATH group. The mean (SD) QALYs per person for 3 years were 1.67 (0.56) in the SCSC group and 1.60 (0.60) in the ATH group. If decision makers are prepared to pay ⩾£2000 to gain 1 QALY, SCSC is likely to be cost effective in 60–90% of cases. Conclusions: The primary economic analysis and sensitivity analyses indicate that SCSC is likely to be more cost effective than ATH in 60–90% of cases. This result seems to be robust to assumptions required by the analysis. This study is one of a limited number of randomised controlled trials to collect detailed resource use and health status data and estimate the costs and QALYs of treatment for established RA. This trial is one of the largest RA studies to use the EuroQol.
影响因子：
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作者：
Fries, JF;Williams, CA;Sibley, J
通讯作者：
Sibley, J