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Báo cáo y học: "Cost-effectiveness of a pressure ulcer quality collaborative"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Cost-effectiveness of a pressure ulcer quality collaborative. | Makai et al. Cost Effectiveness and Resource Allocation 2010 8 11 http www.resource-allocation.eom content 8 1 11 COST EFFECTIVENESS AND RESOURCE ALLOCATION RESEARCH Open Access Cost-effectiveness of a pressure ulcer quality collaborative Peter Makai Marc Koopmanschap Roland Bal and Anna P Nieboer Abstract Background A quality improvement collaborative QIC in the Dutch long-term care sector nursing homes assisted living facilities home care used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers PUs . The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. Methods We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods activities materials . Quality of life Qol weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term three scenarios were created in which change in incidence and prevalence measures were 1 not sustained 2 partially sustained and 3 completely sustained. Results Incidence of PUs decreased from 15 to 4.5 for the 88 patients. Prevalence decreased from 38.6 to 22.7 . Average Quality of Life Qol of patients increased by 0.02 Quality Adjusted Life Years QALY s in two years healthcare costs increased by 2000 per patient the Incremental Cost-effectiveness Ratio ICER was between 78 500 and 131 000 depending on whether the changes in incidence and prevalence of PU were sustained. Conclusions During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care the QIC was probably more costly and more effective in the short run but its long-term .