Cost-effectiveness of bone-anchored prostheses using osseointegrated fixation: Myth or reality?
Cost-effectiveness of bone-anchored prostheses using osseointegrated fixation: Myth or reality?
复制标题
DOI：
10.1177/0309364617740239
复制
发表时间：
2018-06-01
影响因子：
1.5
通讯作者：
Berg, Debra
中科院分区：
文献类型：
--
作者：
Frossard, Laurent Alain;Merlo, Gregory;Berg, Debra
背景：原则上，下肢骨锚定假体可以减轻典型的假体制造和因假体悬浮而产生的残余处理的费用。目的：本研究报告(a)增量成本和(b)健康收益，以及(c)骨锚定假体与套孔悬浮假体相比的成本效益。研究设计：回顾性个体病例对照观察和系统评价。方法：从财务记录中提取实际成本，并在需要超过6年时间范围的16个人队列中完成典型成本。使用文献中提供的与健康相关的生活质量数据计算相应的质量调整生命年的健康收益。结果：提供骨锚定假体的成本比提供套孔悬浮假体高21% - 41%，但质量调整生命年增加17% - 5%。增量成本效益比为每个质量调整生命年$25 700至每个质量调整生命年$53 500，指示性增量成本效益比约为每个质量调整生命年$17 000。骨锚定假体分别为19%和88%的参与者节省成本和成本效益。结论：本研究表明，至少从澳大利亚假肢护理的角度来看，骨锚定假体可能是一种可接受的替代假体。总之，这一初步的基于证据的经济评估为负责全球下肢截肢患者护理政策的决策者提供了一种工作方法。该研究首次从假肢护理的角度提供了基于证据的下肢骨锚定假体与典型的套孔悬浮假体相比的健康经济效益，这对临床医生和负责政策的决策者至关重要。
Background: In principle, lower limb bone-anchored prostheses could alleviate expenditure associated with typical socket manufacturing and residuum treatments due to socket-suspended prostheses.Objective: This study reports (a) the incremental costs and (b) heath gain as well as (c) cost-effectiveness of bone-anchored prostheses compared to socket-suspended prostheses.Study design: Retrospective individual case-controlled observations and systematic review.Methods: Actual costs were extracted from financial records and completed by typical costs when needed over 6-year time horizon for a cohort of 16 individuals. Health gains corresponding to quality-adjusted life-year were calculated using health-related quality-of-life data presented in the literature.Results: The provision of bone-anchored prostheses costed 21%41% more but increased quality-adjusted life-years by 17%5% compared to socket-suspended prostheses. The incremental cost-effectiveness ratio ranged between -$25,700 per quality-adjusted life-year and $53,500 per quality-adjusted life-year with indicative incremental cost-effectiveness ratio of approximately $17,000 per quality-adjusted life-year. Bone-anchored prosthesis was cost-saving and cost-effective for 19% and 88% of the participants, respectively.Conclusion: This study indicated that bone-anchored prostheses might be an acceptable alternative to socket-suspended prostheses at least from a prosthetic care perspective in Australian context. Altogether, this initial evidence-based economic evaluation provided a working approach for decision makers responsible for policies around care of individuals with lower limb amputation worldwide.Clinical relevance For the first time, this study provided evidence-based health economic benefits of lower limb bone-anchored prostheses compared to typical socket-suspended prostheses from a prosthetic care perspective that is essential to clinicians and decision makers responsible for policies.