Sheena Jasley Samonte, Lara Alyssa Liban, Princess Allyza Mondala, Jason Oliver Angeles, Russell Cabus, Patrick Wincy Reyes, Anne Julienne Marfori, Anna Melissa Guerrero, Health Technology Assessment Council
{"title":"OP104 Pilot Implementation Of Health Technology Assessment Topic Prioritization In The Philippines: Lessons And Plans For Moving Forward","authors":"Sheena Jasley Samonte, Lara Alyssa Liban, Princess Allyza Mondala, Jason Oliver Angeles, Russell Cabus, Patrick Wincy Reyes, Anne Julienne Marfori, Anna Melissa Guerrero, Health Technology Assessment Council","doi":"10.1017/s0266462323001174","DOIUrl":"https://doi.org/10.1017/s0266462323001174","url":null,"abstract":"<span>Introduction</span><p>The Health Technology Assessment (HTA) Council in the Philippines carried out its process tracks while the implementing guidelines were being finalized in 2020, due to the urgent need to respond to COVID-19. Two years later, as mandated by the Universal Healthcare (UHC) law, we opened the nominations for the HTA Council’s topic priority list, which will be assessed to inform government financing decisions.</p><span>Methods</span><p>We adopted the former Philippine National Formulary System (PNFS) but set the prioritization criteria according to the decision framework stipulated by the UHC law and allowed industry submissions. We streamlined dossier completion for topics with numerous proponents, supplemented dossier deficiencies, and adjusted the timelines of crucial steps for better reach, while accounting for possible setbacks during the time periods. We satisfied the prioritization criteria using a Delphi technique at the HTA Council subcommittee and Core Committee levels in conjunction with consultations with the Department of Health and the national payer. We also shared evidence base and topic prioritization criteria scores with stakeholders during the public consultation.</p><span>Results</span><p>In the pilot implementation, we processed a total of 140 nominations (88 complete submissions) and released the priority list in five months. After processing 31 appeals from all key stakeholder groups, the 2022 priority list covered 31 assessments based on topics from the Department of Health, the national payer, industry, hospitals, and medical societies. Although we found gaps in the set timelines, inadequacy in the prioritization criteria parameters, and the need to increase exposure of the public to the process, we were able to accommodate all stakeholder concerns and maintain flexibility in the process.</p><span>Conclusions</span><p>We need to update our HTA process guidelines, accept joint dossier submissions, and review our topic prioritization process. The changing health system landscape and transitioning of national health priorities require coordination with the Philippine Food and Drug Administration for horizon scanning, early HTA, and managed entry agreements. Finally, there is a need to create special pathways for rare disease and innovative technologies.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138689509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juntao Yan, Yan Wei, Yi Yang, Shimeng Liu, Yingyao Chen
{"title":"OP74 Analysis Of Literature And Research Foci In Overdiagnosis Based On Citespace","authors":"Juntao Yan, Yan Wei, Yi Yang, Shimeng Liu, Yingyao Chen","doi":"10.1017/s0266462323000971","DOIUrl":"https://doi.org/10.1017/s0266462323000971","url":null,"abstract":"IntroductionWith the rapid development of innovative health technologies, evidence increasingly shows that overdiagnosis is harmful to a person’s health and that it is a global public health issue. This study aimed to analyze the current research status and corresponding foci in the field of overdiagnosis in Chinese and English databases using bibliometric methods.MethodsA search was conducted in the English Web of Science Core Collection database and the Chinese China National Knowledge Infrastructure database for literature published from inception to 31 December 2021. CiteSpace (version 5.8 R1) software was used to perform bibliometric analysis on the countries, institutions, and keyword clusters of the included literature on overdiagnosis and to draw a corresponding visual knowledge map.ResultsA total of 2,841 English and 43 Chinese publications were included. There was an increasing trend in the annual publication volume of both Chinese and English literature, with the publication volume of English research increasing significantly since 2010. In terms of countries and institutions, the top ten in English research on overdiagnosis were all from high income countries. The cooperation among these countries and institutions was close, unlike in China where the cooperation was relatively limited. Analysis of keyword clustering showed that the potential research foci for English literature on overdiagnosis included breast cancer, thyroid cancer, prostate cancer, lung cancer, and other tumor types, whereas the clustering in Chinese records was relatively scattered and mainly focused on overdiagnosis of thyroid cancer.ConclusionsThe research topics in the Chinese literature on overdiagnosis lag significantly behind English research. It is suggested that more research on overdiagnosis and related fields should be actively promoted and conducted in China in the future.","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138689707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ku Nurhasni Ku Abd Rahim, Hanin Farhana Kamaruzaman, Mohamed Hirman Abdullah, Izzuna Mudla Mohamed Ghazali
{"title":"OP61 Value Of Disinvestment: The Journey From Possibility To Reality","authors":"Ku Nurhasni Ku Abd Rahim, Hanin Farhana Kamaruzaman, Mohamed Hirman Abdullah, Izzuna Mudla Mohamed Ghazali","doi":"10.1017/s0266462323000909","DOIUrl":"https://doi.org/10.1017/s0266462323000909","url":null,"abstract":"IntroductionIn recent years, most countries have struggled to meet the annual demand for increases in healthcare resources. This scenario poses a significant challenge for those who pay for or manage healthcare services, namely the clinicians and hospital managers Thus, value-based implementation for resource allocation may include disinvestment initiatives to maximize benefits to patients and the population. The purpose of this study was to explore the feasibility of incorporating a systematic and explicit value assessment in hospital-based decision-making for the prioritization of resource allocation.MethodsAn evidence-informed stakeholder engagement workshop was held with approximately 50 hospital directors and utilized a scenario analysis of making decisions for hospital procurement. The key question discussed was what should be considered when making decisions about resource allocation and disinvestment in health services at the hospital level. The participants were divided into five groups with a mix of multilevel institutional categories. Each group was given a similar resource allocation scenario, a wish list, and a shift list. The participants were involved in a facilitated discussion on the process, criteria for prioritization, and the justification of their final selections. Subsequently, a deliberative discussion was held at the end of the workshop to explore the feasibility of this prioritization method.ResultsPrioritization criteria that were identified and unanimously agreed upon included effectiveness, safety, burden of disease, suitability of services, human resources and facilities, and economic considerations. The deliberative discussion also highlighted the impact of the disinvestment of services, managing the expectation of patients and clinicians, and monitoring and audit mechanisms.ConclusionsThe value of disinvestment should not compromise access to services and quality of care. There is a huge potential for implementing a systematic and explicit value assessment in hospital-based decision-making for prioritization of resource allocation. Further refinement of the process and mitigation of challenges will enable its use.","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138693223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PP80 The Value of Intraoperative Neural Monitoring During Thyroid Surgery In China: A Literature Review","authors":"Yutong Yang, Yin Song","doi":"10.1017/s0266462323002118","DOIUrl":"https://doi.org/10.1017/s0266462323002118","url":null,"abstract":"<span>Introduction</span><p>Recurrent laryngeal nerve (RLN) injury has been a frequent source of malpractice litigation following thyroid surgery. Intraoperative neural monitoring (IONM) has been widely applied to avoid RLN injury in thyroid surgery in developed countries, but China cannot achieve the same application rate currently. To improve the recognition and application of IONM in China, this literature review aims to synthesize the evidence on the value of IONM in China.</p><span>Methods</span><p>A comprehensive literature review was conducted by searching through PubMed, CNKI and Wan Fang to identify studies about the IONM technology for protecting RLN during thyroid surgery in Chinese clinical data.</p><span>Results</span><p>Nineteen Chinese clinical trials of IONM during thyroid surgery published from 2012 to 2022 were included for review. Almost all studies recruited adults who need thyroid surgery and only one study enrolled geriatric patients. There were three (3/19) prospective studies and two were randomized controlled trials that both showed that IONM helped surgeons to detect the RLN with less time and reduce the injury of RLN in reoperative thyroid surgery. Major studies (16/19) conducted retrospective analysis and six of them (6/16) only had an IONM group that showed that IONM technology can avoid damage to the RLN. The remaining ten studies (10/16) compared patients with and without IONM during the surgery. Compared with the non-IONM group, nine studies (9/10) stated IONM technology has an advantage in the reduction of RLN injury rate and seven studies (7/10) claimed IONM was helpful in reducing the time of surgery. One study believed IONM was beneficial to reducing bleeding during the surgery and another study reported a lower incidence of hypoparathyroidism with the IONM group.</p><span>Conclusions</span><p>The value of IONM for protecting RLN during thyroid surgery and improving operation efficiency has been thoroughly proven by the above Chinese clinical trials. Further economic evaluations and patient-reported outcomes research of IONM with Chinese hospital data will help better assess the value of IONM.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138631666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Enkeleint A. Mechili, Elena Petelos, Jorgjia Bucaj, Parisis Gallos
{"title":"PP109 The Use Of Health Technology Assessment In Decision Making: Evidence From The Balkan Countries","authors":"Enkeleint A. Mechili, Elena Petelos, Jorgjia Bucaj, Parisis Gallos","doi":"10.1017/s0266462323002313","DOIUrl":"https://doi.org/10.1017/s0266462323002313","url":null,"abstract":"<span>Introduction</span><p>According to the most recent definition health technology assessment (HTA) “is a multidisciplinary process that uses explicit methods to determine the value of a health technology at different points in its lifecycle. The purpose is to inform decision-making in order to promote an equitable, efficient, and high-quality health system”. This article aimed to evaluate implementation of HTA in decision making in the Balkan countries.</p><span>Methods</span><p>A scoping review of the existing literature took place to locate relevant scientific articles, policy papers and documents released by the respective Ministries. We searched data for 6 Western Balkan countries (Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia) and didn’t focus on those countries that are part of the European Union (EU). For the literature search key words were used, while documents only in English were included in the analyses. Additionally, the search was conducted for the period January 2010 until October 2022.</p><span>Results</span><p>The Western Balkan countries are in process of integration to the EU and based on this they are trying to make improvement in different sectors including health services. However, the use of HTA in most of the studied countries is in its preliminary phase. Most of the countries have established HTA bodies or specific authorities but with limited resources (both human and financial). Additionally, their reports are non-binding for policy makers and healthcare decisions are taken based on experts’ opinions and not an extensive HTA analyses.</p><span>Conclusions</span><p>Despite their efforts, the Western Balkan countries need to improve and considerably increase the use of HTA in decision-making. Its use can help in provision of better healthcare services as well as to decrease costs. Specific attention should be put on human and financial resources that are lacking in all settings.</p><p>Western Balkan countries need to put much more efforts for harmonization of their legal framework with that of the EU countries.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138631676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophie Edwards, Julie Hahn-Pedersen, Danielle Robinson, Mei Sum Chan, Benjamin Bray, Alice Clark, Milana Ivkovic, Wojciech Michalak, Christian Wichmann, Sasha Berry, Marc Evans
{"title":"PP140 Burden of Illness And Health Care Costs In People with Alzheimer’s Disease","authors":"Sophie Edwards, Julie Hahn-Pedersen, Danielle Robinson, Mei Sum Chan, Benjamin Bray, Alice Clark, Milana Ivkovic, Wojciech Michalak, Christian Wichmann, Sasha Berry, Marc Evans","doi":"10.1017/s0266462323002489","DOIUrl":"https://doi.org/10.1017/s0266462323002489","url":null,"abstract":"<span>Introduction</span><p>Alzheimer’s disease (AD), the most common cause of dementia, is becoming increasingly prevalent worldwide. Understanding the current burden of AD is important in health economic evaluations of new therapies. We aimed to estimate the burden of illness, and healthcare costs of people living with AD using a large, comprehensive real-world database in England.</p><span>Methods</span><p>A retrospective cohort study was undertaken in the Discover-NOW dataset, a real-world database containing the linked primary and secondary care electronic health records of ˜3 million people living in North West London, England. Patients diagnosed with AD were followed from the later of 1 January 2010 or AD diagnosis date, to the earlier of 31 December 2021 or end of follow up (maximum 10 years). Baseline prevalence of 33 comorbidities, incidence of 7 outcomes (survival, cardiovascular, care home admission, hepatic and renal outcomes), healthcare resource utilisation and total direct healthcare costs (using National Health Service tariffs and unit cost approaches) were calculated.</p><span>Results</span><p>Of 18,116 patients diagnosed with AD, at baseline the mean age was 81 years, 62 percent were female, 65 percent were White, 16.5 percent Asian and 8.9 percent Black. At baseline, hypertension prevalence was 60.2 percent, chronic kidney disease 35.5 percent and Type 2 diabetes 22.4 percent. The highest incidence rates across these outcomes were 13.4 (95% confidence interval [CI]:12.2,14.7) per 1,000 person years for stroke, 7.5 (95% CI: 6.6, 8.5) for myocardial infarction, and 83.6 (95% CI: 80.1, 87.0) for care home admission. Median survival was 4.9 years from diagnosis. Their annual total direct healthcare cost was GBP4,547 per patient, of which 58 percent were from hospital admissions. The majority (75%) of healthcare contacts were from primary care. AD patients had an average length of stay of 11.5 days per inpatient admission, and spent on average one week per year as inpatients.</p><span>Conclusions</span><p>AD is associated with high direct healthcare costs, with patients’ annual costs ˜1.7 times that of the UK population. The majority of these costs are associated with inpatient hospital admissions.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138631677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PP135 The Cost-Of-Illness Of The Management Of Patients Affected By Hyperparathyroidism In The Italian Healthcare Setting","authors":"Michele Basile, Debora Antonini, Agostino Fortunato, Americo Cicchetti","doi":"10.1017/s0266462323002465","DOIUrl":"https://doi.org/10.1017/s0266462323002465","url":null,"abstract":"<span>Introduction</span><p>Hyperparathyroidism is a medical condition characterized by an excess of parathyroid hormone (PTH) in the blood. This hormone is produced by the parathyroid glands, located behind the thyroid gland. PTH plays a crucial role in regulating calcium levels in the body, which is necessary for muscle activity, nerve transmission, and maintaining bone density. In this study, the authors aimed to determine the parameters necessary for defining the delivery process of interventions for managing hyperparathyroidism.</p><span>Methods</span><p>To achieve this, a group of Key Opinion Leaders (KOLs) was surveyed using a questionnaire to investigate specific drivers such as the duration of interventions, drug therapies employed, and materials required. The authors also estimated the indirect costs associated with patients and caregivers. The economic analysis considered the perspectives of both the Italian National Health Service (SSN) and the community. The analysis was conducted using Activity Based Costing (ABC) methods to determine the full cost sustained for a parathyroidectomy surgery and pharmacological therapies per patient treated, as well as the average resources absorbed by a patient managed through pure surveillance.</p><span>Results</span><p>The results showed that the average annual cost of parathyroidectomy and pharmacological therapies per patient was EUR5,193.20 and EUR1,726.96, respectively. Productivity losses due to the interventions amounted to EUR858.21 and EUR66.80 for the patient and caregiver, respectively. The pure surveillance strategy incurred an average yearly cost of EUR197.42.</p><span>Conclusions</span><p>The study’s major limitation was the lack of evidence available concerning the therapies under analysis, particularly in the Italian context. Nonetheless, the survey of clinicians provided useful insights into the expenditures associated with implementing interventions for managing hyperparathyroidism. In conclusion, managing hyperparathyroidism involves considerable costs, and healthcare providers must consider the perspectives of both the SSN and the community when estimating the economic impact of interventions. The authors’ analysis provides insights into the cost of different interventions, which could help healthcare providers make informed decisions when managing hyperparathyroidism.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138631732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PP96 Continuous Innovation In Neurostimulation Therapies For The Management Of Chronic Pain: Challenges For Health Technology Assessment Policy","authors":"Rashmi Joglekar, Liesl Strachan","doi":"10.1017/s0266462323002210","DOIUrl":"https://doi.org/10.1017/s0266462323002210","url":null,"abstract":"<span>Introduction</span><p>Chronic pain is a debilitating condition with a high burden of disease. Neurostimulation therapy is an established modality for patients with chronic pain refractory to pharmacological based approaches and conservative interventional therapies. The therapy has evolved over the decades, based on improved understanding of the mechanisms of action, as well as technological advancement in device design.</p><p>Our objective is to conduct a review of the innovation in neurostimulation therapy for chronic pain, in the context of health technology assessment (HTA), and its implications on policies related to patient access.</p><span>Methods</span><p>A qualitative literature review was conducted to identify published HTAs, systematic reviews, clinical guidelines and other relevant articles and reports on neurostimulation therapies used in pain management. Searches were limited to the past 10 years to ensure that a contemporary analysis was conducted.</p><span>Results</span><p>Our review indicates that there has been continuous innovation in neurostimulation therapies for chronic pain. This includes improvements in battery longevity and reduced size, advances in the design of leads, the development of novel stimulation waveforms and personalized programming using sophisticated algorithms including sensing and feedback loops, and remote management to name a few. Clinical research has also enabled an expansion in the range of neural targets and indicated subpopulations. The literature shows that apart from reduction in pain, neurostimulation therapy facilitates improvements in the quality of life, and reduction in opioid dependence, carer burden and disability, which are outcomes important to patients as well as to society at large. Clinical guidelines are largely supportive of neurostimulation for the management of chronic refractory pain in carefully selected patients.</p><span>Conclusions</span><p>The range and complexity of neurostimulation devices and the variety of study designs presents a challenge for evidence synthesis. HTA bodies need to ensure that the methodologies for evaluating a heterogeneous therapy such as neurostimulation for pain management are robust, and that the policies for determining access to such innovative therapies are patient-centric and fit-for-purpose.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138631733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carla Fernández-Barceló, Ismail Abbas, Guido Muñoz, Joan Sanchez, Ricard Mellado-Artigas, Carlos Ferrando, Laura Sampietro-Colom
{"title":"OP72 Innovating To Decrease Mortality And Resource Use In Surgical Inpatients: The ZERO Project","authors":"Carla Fernández-Barceló, Ismail Abbas, Guido Muñoz, Joan Sanchez, Ricard Mellado-Artigas, Carlos Ferrando, Laura Sampietro-Colom","doi":"10.1017/s026646232300096x","DOIUrl":"https://doi.org/10.1017/s026646232300096x","url":null,"abstract":"IntroductionInterest in early detection of complications in hospitals has increased recently. Complications after elective or urgent surgery are frequent and are associated with higher mortality rates, longer hospital stays, and more resource utilization. The ZERO project implemented an educational nursing program and developed an innovative algorithm that assesses a patient’s complication risk based on clinical parameters to prevent complications and reduce hospital burden. Our aim was to present the results from one year of implementing ZERO at the Clinic Barcelona University Hospital.MethodsA comparative effectiveness and cost study was conducted. Data from patients admitted after elective or urgent surgery were collected for one year retrospectively (n=8,844 from January 2019 to December 2019) and prospectively (ZERO) (n=8,163 from October 2021 to October 2022). Effectiveness was measured in terms of mortality, complications, and life-years gained (LYG). Length of stay (LoS) at conventional, intermediate, and intensive care units and rates of readmissions were collected for resource use. The chi-square test was used to compare categorical variables. The t-test and Wilcoxon test were used for normally and non-normally distributed continuous variables, respectively.ResultsThere was a significant decrease in the rate of complications (7.8%, 95% confidence interval [CI]: -8.46, -7.19; p<0.001) with ZERO. Moreover, there were statistically significant reductions in mean LoS for readmissions to conventional wards (-5.04 days, 95%CI: -9.9, -0.18; p=0.04) and to the intensive care ward within the same episode (-4.68 days, 95%CI: -9.26, -0.14; p=0.02). The mean cost per patient was EUR2,772.92 and EUR2,591.57 before and after ZERO implementation, respectively. After accounting for the cost of implementing ZERO, there was a cost saving of EUR147.76 per patient (p=0.048), which yielded a yearly impact of EUR1,206,165 for the hospital budget.ConclusionsThis one-year analysis of the effect of ZERO on surgical patients shows that it decreases complication rates and all types of LoS, leading to overall cost savings for the hospital.","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138689180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shimeng Liu, Yanfeng Ren, Jing Liu, Yan Wei, Yingyao Chen
{"title":"OP24 Preferences Of Depressed And Depression-Prone Groups With Regard To Antidepressants In China: A Best-Worst Scaling Survey","authors":"Shimeng Liu, Yanfeng Ren, Jing Liu, Yan Wei, Yingyao Chen","doi":"10.1017/s0266462323000697","DOIUrl":"https://doi.org/10.1017/s0266462323000697","url":null,"abstract":"IntroductionAntidepressants are one of the main treatment approaches for depression, and previous evidence suggests that consideration of patient preferences can improve their adherence to medication regimens. The objective was, therefore, to evaluate the preferences of depressed and depression-prone groups in China with respect to antidepressant medications.MethodsAn online survey with best-worst scaling choices was administered in depressed and depression-prone patients. The balanced independent block design generated 13 choice task profiles for each participant to answer, with each choice set consisting of four alternatives out of 13 antidepressant-specific attributes. Count analysis and a conditional logit model were used to estimate the relative importance of the 13 attributes and preference heterogeneity.ResultsThe analytical sample included 210 participants, comprising 49 individuals who had previous experience with depression and 161 who were depression prone. Participants in both groups preferred medications with a low risk of liver or kidney damage, headache or dizziness, and recurrence. There were significant differences in both groups regarding out-of-pocket costs and duration of medication. The K-means clustering further proved preference heterogeneity among the patients.ConclusionsOur study revealed patient preferences for antidepressant medication choices in China. Healthcare decision makers should consider and discuss patient preferences in the treatment decision-making process to improve patient adherence to and satisfaction with medications, and to ultimately improve patient outcomes.","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138689176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}