Using a cost-benefit analysis to estimate outcomes of a clinical treatment guideline: Testing the brain trauma foundation guidelines for the treatment of severe traumatic brain injury
Using a cost-benefit analysis to estimate outcomes of a clinical treatment guideline: Testing the brain trauma foundation guidelines for the treatment of severe traumatic brain injury
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DOI：
10.1097/ta.0b013e3181493080
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发表时间：
2007-12-01
影响因子：
--
通讯作者：
Sattin, Richard W.
中科院分区：
文献类型：
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作者：
Faul, Mark;Wald, Marlena M.;Sattin, Richard W.
背景资料：脑创伤基金会（BTF）颁布治疗指南十年后，很少有研究探讨这些指南对严重创伤性脑损伤（TBI）患者的应用。这些研究都报告了节省成本和降低mortals.Materials：我们预测的结果，以前的研究BTF指南采用估计的影响，在美国各地广泛采用。我们使用监测系统和全国调查来估计严重创伤性脑损伤患者的数量，并将采用BTF的终身成本与目前的治疗状况进行比较。在检查了健康结果和成本后，我们估计每年的医疗费用将大大节省如果更经常地使用治疗指南，将实现每年康复费用（4300万美元）和终身社会费用（38.4亿美元）。执行费用估计为6 100万美元。净节余主要是因为健康结果改善，终身社会支助系统的负担减轻。我们还估计，死亡率将减少3,607生活，如果guidelines were followed.Conclusions：广泛采用的BTF指南治疗严重的TBI将导致大量节省的成本和生命。节省的大部分成本是社会成本。进一步的验证工作，以确定最有效的方面的BTF准则是必要的。
Background: A decade after promulgation of treatment guidelines by the Brain Trauma Foundation (BTF), few studies exist that examine the application of these guidelines for severe traumatic brain injury TBI) patients. These studies have reported both cost savings and reduced mortality.Materials: We projected the results of previous studies of BTF guideline adoption to estimate the impact of widespread adoption across the United States. We used surveillance systems and national surveys to estimate the number of severely injured TBI patients and compared the lifetime costs of BTF adoption to the current state of treatment.Results: After examining the health outcomes and costs, we estimated that a substantial savings in annual medical costs ($262 million), annual rehabilitation costs ($43 million) and lifetime societal costs ($3.84 billion) would be achieved if treatment guidelines were used more routinely. Implementation costs were estimated to be $61 million. The net savings were primarily because of better health outcomes and a decreased burden on lifetime social support systems. We also estimate that mortality would be reduced by 3,607 lives if the guidelines were followed.Conclusions: Widespread adoption of the BTF guidelines for the treatment of severe TBI would result in substantial savings in costs and lives. The majority of cost savings are societal costs. Further validation work to identify the most effective aspects of the BTF guidelines is warranted.