Risk Management and Healthcare Policy最新文献

{"title":"CT-Detected Arterial Calcification and Ischemic Cardiovascular Risk Assessment in Patients with Upper Urinary Tract Calculi: A Case-Control Study.","authors":"Zhan Qu, Wenbo Yang, Shijun Liu, Mingqing Wang, An Zheng, Caipeng Qin, Yiqing Du, Xiaodong Zhu, Tao Xu","doi":"10.2147/RMHP.S510109","DOIUrl":"https://doi.org/10.2147/RMHP.S510109","url":null,"abstract":"<p><strong>Objective: </strong>Arterial calcification (AC) is frequently observed in computed tomography (CT) scans of patients with upper urinary tract calculi (UUTC). This study aimed to investigate the relationship between AC detected by CT in UUTC patients and the risk of ischemic cardiovascular diseases (ICVD).</p><p><strong>Methods: </strong>In this retrospective case-control study, clinical data of 596 patients were collected. Bone mineral density (BMD) of L1 vertebra and calcification of major/medium arteries were analyzed. Differences in clinical data, CT images and 10-year ICVD risk scores were compared between groups. Univariate analysis and multivariate logistic regression identified independent risk factors for AC in UUTC patients. A scoring system to assess concurrent AC risk in UUTC patients was developed and validated.</p><p><strong>Results: </strong>A total of 396 UUTC patients and 200 controls were included. AC prevalence was higher in UUTC group (71.7% vs 63.5%, <i>P</i> = 0.041), remained valid after controlling for specific confounding factors. UUTC patients exhibited lower BMD of L1 vertebra. Their 10-year ICVD risk scores were elevated (male: OR = 2.450, 95% CI = 1.262-4.758, <i>P</i> = 0.007; female: OR = 4.340, 95% CI = 2.203-8.550, <i>P</i> < 0.001). Multivariate analysis confirmed L1 vertebra BMD < 160 Hounsfield units (OR = 3.660, 95% CI = 2.107-6.358, <i>P</i> < 0.001) as an independent AC risk factor. The presence of AC was associated with a 13.7-fold increased odds of high-risk group classification (OR = 13.689, 95% CI = 8.021-23.346, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>AC and the risk of ICVD are associated with UUTC. Our study establishes an innovative integration of UUTC with CT-based AC assessment and ICVD risk stratification, highlighting the need for cardiovascular surveillance in UUTC-affected individuals.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1419-1427"},"PeriodicalIF":2.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Status and Influencing Factors of Nursing Care Insufficiency in Intensive Care Units: A Cross-Sectional Study Focusing on Staff Shortages, Workload, and Care Omissions.","authors":"Yan Yang, Lihua Zhou, Lin Zhang, Miao Wang, Shaohua Hu","doi":"10.2147/RMHP.S494860","DOIUrl":"https://doi.org/10.2147/RMHP.S494860","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the status of nursing care omissions in intensive care units (ICUs) in China and identify factors influencing these omissions.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 1162 ICU nurses from 30 hospitals across nine provinces in China. Data were collected using questionnaires on nursing care omissions, clinical leadership (nurses' ability to influence and coordinate care), and safety attitudes (perceptions of safety culture). Descriptive statistics, correlation analysis, and multiple linear regression were performed using SPSS.</p><p><strong>Results: </strong>The mean score for nursing care omissions is 57.38±21.27, clinical leadership is 59.13±15.30, and safety attitudes is 119.00±21.16. A negative correlation is observed between ICU nursing care omission scores and clinical leadership scores (r=-.212, p<0.001), and a negative correlation is observed between ICU nursing care omission scores and safety attitude scores (r=-.241, p<0.001). The multiple linear regression analysis indicates that the factors influencing nursing care omissions in the ICU includes nurses' age, position, personnel relationships, average monthly income, satisfaction with the ward teamwork, frequency of patient safety education, and clinical leadership and safety attitudes (p<0.05).</p><p><strong>Conclusion: </strong>This study found that nursing deficiency in ICU is significant, affecting patient safety, nurse burnout, and nursing quality. Key factors include nurse age, position, and so on. It is recommended to strengthen clinical leadership training, improve safety culture, and optimize staffing to reduce nursing omissions and improve patient outcomes. It calls on health policies to pay attention to ICU nursing deficiencies and formulate support measures to ensure patient safety and nurse health.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1407-1417"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Awareness and Approaches of People Between the Ages of 19-60 in a Rural Area of Antalya Province About Blood Stem Cell Donation and Bone Marrow Donation.","authors":"Alparslan Merdin, Ümit Aydın","doi":"10.2147/RMHP.S514701","DOIUrl":"https://doi.org/10.2147/RMHP.S514701","url":null,"abstract":"<p><strong>Purpose: </strong>While hematopoietic stem cell transplantation is commonly associated with stem cell procedures in public discourse, \"stem cell\" remains a broad classification. More precise terminology such as \"blood stem cell transplantation\", \"bone marrow transplantation\", or \"bone marrow stem cell transplantation\" may better characterize hematopoietic stem cell procedures in both public and academic contexts. This study aimed to evaluate public comprehension of these specific terms and to assess awareness and attitudes toward stem cell donation, with particular focus on rural populations.</p><p><strong>Materials and methods: </strong>The study recruited 250 participants aged 19-60 years from rural Aksu District, Antalya Province. Individuals with a history of stem cell transplantation, those with a first-degree relative with a history of stem cell transplantation, and healthcare professionals were excluded from the study. The participants were asked 11 questions about their approach to stem cell donation and their thoughts on the subject.</p><p><strong>Results: </strong>Among the 250 participants, 51.6% (n=129) expressed willingness to become stem cell donors, whereas 48.4% (n=121) reported no willingness to be a donor. Interestingly, 95.6% (n=239) of the participants stated that they would like to know the identity of the person to whom they would be donating stem cells.</p><p><strong>Conclusion: </strong>This study underscores the need to revisit current anonymity regulations in stem cell transplantation, particularly when both donor and recipient express a desire for mutual identification. Updating regulatory protocols and codes to facilitate information exchange in such cases might be better. Moreover, if the recipient may require further donations from the same donor, the donor should be consulted pre-transplantation about their willingness to provide further support. Their preferences should also be considered in the treatment approach when necessary.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1397-1405"},"PeriodicalIF":2.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Christmas Break: Predictive Value of Holiday Avian Wishbone Traditions Among Frontline Healthcare Workers in a Prospective Trial.","authors":"Gideon Loevinsohn, Caitlin N Wizda, Tiffany R Glynn, Timothy B Erickson, Peter R Chai","doi":"10.2147/RMHP.S509590","DOIUrl":"10.2147/RMHP.S509590","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of winning a wishbone contest on the likelihood of subsequent goal attainment.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>A large urban academic emergency department in the United States.</p><p><strong>Participants: </strong>40 frontline emergency department clinicians including supervising and resident physicians and physician assistants. Participants were enrolled between December 8, 2023 and January 10, 2024 and followed for three months.</p><p><strong>Main outcome measures: </strong>The primary outcomes were feasibility of performing wishbone contests in the emergency department and attainment of a pre-specified wish by the end of the three-month follow-up period.</p><p><strong>Results: </strong>Forty participants who met eligibility criteria were enrolled in the study and 37 completed follow-up at three months. Half identified as female and professional roles (resident physician, attending physician and physician assistant) were equally distributed. Overall, 38% of wishes were realized at three month follow-up. There was no association between winning the wishbone competition and realizing the wish. Participants who perceived a greater degree of control over the outcome of their wish were more likely to have their wish realized (RR1.2, 95% CI 1.05-1.37).</p><p><strong>Conclusion: </strong>Frontline healthcare workers will engage in luckiness-boosting wishbone contests even in a busy emergency department environment. In our study, there was no association between winning the wishbone competition and goal or wish achievement. Participants who reported and perceived a greater degree of control over the outcome of their wish, however, were more likely to have their wish realized. Holiday cheer and wishful thinking traditions may indicate the feasibility of future work in extending positive thinking among frontline healthcare workers.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1387-1396"},"PeriodicalIF":2.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Correlates of Mental Health Problems in Resident Physicians in Inner Mongolia Autonomous Region: A Cross-Sectional Study.","authors":"Yan Zhang, Li Zhang, Jianyu Que, Miao Jia, Xi Nan, Juanniu Zhang, Haifei Gao, Lixia Chen","doi":"10.2147/RMHP.S494326","DOIUrl":"https://doi.org/10.2147/RMHP.S494326","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the prevalence and contributory factors of mental health issues, including anxiety, depression, and insomnia, among resident physicians. Additionally, it endeavors to understand the complex characteristics of these issues across different demographic groups.</p><p><strong>Methods: </strong>Using an online cross-sectional design, the study engaged resident physicians in Inner Mongolia, China, through convenience sampling. Questionnaires collected data on sociodemographic background, training details, and symptoms of depression, anxiety, and insomnia, assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI). Conduct latent class analysis on psychological issues using Mplus software. Analyze the related influencing factors of different group characteristics using a multivariate logistic regression model.</p><p><strong>Results: </strong>The study comprised 2891 resident physicians, revealing that 20.3% experienced moderate to severe anxiety, 19.72% had moderate to severe depression, and 9.6% faced moderate to severe insomnia. Latent class analysis identified three distinct mental health groups: a high anxiety-depression-insomnia group, a low anxiety-depression-healthy sleep group, and a moderate anxiety-mild depression-variable insomnia group. Factors such as training stage, professional accomplishments, self-reported medical errors, self-esteem, perceived stress, and social support were significantly associated with mental health issues, as identified by multivariate logistic regression.</p><p><strong>Conclusion: </strong>The mental health problems among residents are prominent. By analyzing mental health status and influencing factors, residents can be categorized into different groups, allowing for more targeted interventions. These interventions may include stress management, communication skills training, crisis intervention, and the development of support systems, along with improvements to the work environment and a focus on humanistic care.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1377-1385"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Correlation Between Patient Safety Culture and Adverse Medical Events Using Failure Mode and Effect Analysis (FMEA).","authors":"Yang Cui, Yu Wang, He Liu, Shaojie Xu, Xue Zhang","doi":"10.2147/RMHP.S502725","DOIUrl":"https://doi.org/10.2147/RMHP.S502725","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the correlation between medical safety adverse events and patient safety culture through the lens of Failure Mode and Effect Analysis (FMEA).</p><p><strong>Methods: </strong>Sixty patients from a hospital were selected as the research subjects, alongside 440 medical staff members (including clinical, medical technology, and management personnel) who participated in the study. The general demographic characteristics of medical staff, patient safety culture, and adverse medical safety events were investigated. FMEA was employed to analyze the relationship between medical safety adverse events and patient safety culture, using the risk priority number (RPN) as a key metric.</p><p><strong>Results: </strong>A comparison of RPN values before and after FMEA intervention revealed that the RPN values of each failure mode significantly decreased post-intervention. Correlation analysis showed significant relationships between medication errors and several factors: \"incident reporting frequency\" (OR=0.706), \"manager expectations and actions to promote patient safety\" (OR=0.733), and \"management support for patient safety\" (OR=0.755). Pressure ulcers were significantly correlated with \"manager expectations and actions to promote patient safety\" (OR=0.729) and \"shift and transfer\" (OR=0.707). Falls were notably associated with \"interdepartmental cooperation\" (OR=0.735), \"feedback and communication about errors\" (OR=0.756), and \"shift and transfer\" (OR=0.660). Additionally, a strong correlation was identified between adverse events and \"management support for patient safety\" (OR=0.701).</p><p><strong>Conclusion: </strong>Utilizing FMEA to analyze the correlation between medical safety adverse events and patient safety culture is effective in identifying specific dimensions of these events related to safety culture. This enables the development of targeted interventions to mitigate adverse events and enhance patient safety.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1367-1376"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Feasibility and Effectiveness of an Interdisciplinary Verbal De-Escalation and Implicit Bias Check Training for Agitation Management in the Emergency Department.","authors":"Jossie A Carreras Tartak, Giovanni Rodriguez, Madeline Schwid, Melissa A Meeker, Matthew D Thomas, Harold J Roy, Farah Z Dadabhoy, Melanie Molina, Anita Chary, Alice K Bukhman, Dana D Im, Elizabeth S Temin, Wendy L Macias-Konstantopoulos","doi":"10.2147/RMHP.S513026","DOIUrl":"https://doi.org/10.2147/RMHP.S513026","url":null,"abstract":"<p><strong>Purpose: </strong>Recent scholarship has revealed racial disparities in emergency department (ED) physical restraint use in agitation management. We implemented an interdisciplinary educational program that integrates discussions about the role of bias in physical restraint use with workplace violence (WPV) prevention strategies to increase awareness of implicit bias and comfort with verbal de-escalation among ED staff.</p><p><strong>Patients and methods: </strong>In partnership with hospital security at a large urban academic medical center, we developed a 1-hour online WPV prerequisite course followed by a 2-hour multi-modal, in-person training consisting of 40 minutes each of didactics, an interactive defensive skills workshop, and case-based simulations with structured debriefings. From September 2022 to June 2023, all patient-facing ED staff were invited to participate and received a $100 gift card for program completion. Participants rated their confidence and comfort in various aspects of agitation management on a 5-point Likert scale before and immediately after via pre- and post-training surveys. Wilcoxon matched-pairs tests were employed for analysis.</p><p><strong>Results: </strong>Of 91 participants, 72 (79%) completed the pre- and post-training surveys. Representing a wide range of ED role groups, 74% of participants were clinical staff and a majority had 0-5 years of experience (65%). Among all participants, there was a statistically significant improvement in confidence and comfort with the various aspects of agitation management across all 11 questions (p<0.001). A similar change was observed among the clinical staff (p<0.001), however, the degree of improvement observed among those with greater than 5 years of experience was less dramatic than among clinical staff with 0-5 years of experience.</p><p><strong>Conclusion: </strong>Interdisciplinary multi-modal training can improve confidence and comfort with verbal de-escalation and implicit bias checks in team-based agitation management. Additional research is needed to understand if such integrated training can also reduce physical restraint use, racial disparities in restraint use, and WPV events.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1355-1366"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Symptom Cluster in NSCLC Patients and Its Relationship with Social Support and Self-Efficacy: A Cross-Sectional Study.","authors":"Juan Cao, Keyu Chen, Lihong Gao, Dandan Yang, Wenjuan Zhang, Xiaheng Deng, Changpeng Liu, Qi Dai, Xinyi Xu, Fang Li","doi":"10.2147/RMHP.S518188","DOIUrl":"https://doi.org/10.2147/RMHP.S518188","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to identify symptom clusters among NSCLC patients within 3 months postoperatively and analyze the relationships between symptom clusters and social support and self-efficacy.</p><p><strong>Methods: </strong>We conducted a cross-sectional study from January 1 to May 31, 2024, involving NSCLC patients undergoing surgery at hospitals in Jiangsu Province. Data were collected using the MD Anderson Symptom Inventory, the Perceived Social Support Scale (PSSS), and the Strategies Used by People to Promote Health (SUPPH).</p><p><strong>Results: </strong>Exploratory factor analysis revealed five distinct symptom clusters: respiratory distress, respiratory tract discomfort, physical exhaustion, digestive dysfunction, and nighttime disturbances. The severity of physical exhaustion and nighttime disturbances was negatively correlated with PSSS scores. Conversely, the severity of respiratory distress, respiratory tract discomfort, and digestive dysfunction symptoms was negatively correlated with SUPPH scores.</p><p><strong>Conclusion: </strong>Our findings may guide medical professionals in managing postoperative symptoms in NSCLC patients. Social support and self-efficacy appear to be significant factors influencing the severity of symptom clusters.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1347-1354"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Autonomy Reform on the Efficiency of Public Hospitals in China: A DEA-ITSA Combination Analysis.","authors":"Ningbo An, Quan Zou, Ji-Bin Li, Kaiyuan Luo, Gang Sun, Xing Ni, Oudong Xia","doi":"10.2147/RMHP.S514512","DOIUrl":"https://doi.org/10.2147/RMHP.S514512","url":null,"abstract":"<p><strong>Purpose: </strong>Since 2014, China has been rolling out a new autonomy reform for public hospitals, aiming to enhance their efficiency and better utilize the health budgets. The purpose of this research is to assess the reform's success and explore its effects on hospital outcome efficiency, laying a foundation based on empirical evidence for future policy decisions.</p><p><strong>Methods: </strong>The data envelopment analysis(DEA) and interrupted time-series analysis (ITSA) approaches were combined to analyze the reform impacts on the 16 samples of Shenzhen municipal public hospitals in China, using data extracted from the Shenzhen Health Statistics Yearbook from 2002 to 2023.</p><p><strong>Results: </strong>The results revealed that from 2002 to 2023, 15 out of 16 sample hospitals achieved total factor productivity improvement in Shenzhen city of China, with the average growth rate of Malmquist total factor productivity index(MI) was 3.05% and the highest growth rate was 6.93%, yet only one hospital showing a growth rate of -0.02%. The results of ITSA show a significant intervention in 2014. After the policy intervention, the fixed reference Malmquist total factor productivity index(FRMI) for the general and the specialty hospital group increased at rates of 0.04680(P<0.000) and 0.1746(p<0.000) per year by the Newey-West model, similarly, the rates of 0.04689(P<0.000) and 0.1762(p<0.000) per year by the Prais-Winsten model.</p><p><strong>Conclusion: </strong>The reform has positively impacted public hospitals' total factor productivity(TFP). The TFP of the general hospitals was increasing before the policy intervention of autonomy hospitals, but the time of its implementation was associated with a more significant rise. Meanwhile, the TFP of specialty hospitals decreased before the intervention; however, its trend shifted to growth after the intervention. This research further emphasizes the applicability of the DEA-ITSA combination method as an effective tool for health policies evaluation using public data within China's healthcare framework.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1333-1346"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Analysis of Serplulimab Combined with Nab-Paclitaxel Plus Carboplatin Compared to Nab-Paclitaxel Plus Carboplatin Alone as First-Line Treatment for Advanced Squamous Non-Small Cell Lung Cancer in China.","authors":"Hongting Yao, Kai Xu, Man Yu, Xiaoye Wang, Yingzhi Lu, Xin Li, Hong Wu","doi":"10.2147/RMHP.S506976","DOIUrl":"https://doi.org/10.2147/RMHP.S506976","url":null,"abstract":"<p><strong>Purpose: </strong>The ASTRUM-004 trial demonstrated the efficacy of serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy in untreated patients with advanced squamous non-small cell lung cancer (NSCLC). Our study aimed to evaluate the cost-effectiveness of this combination therapy compared to that of nab-paclitaxel plus carboplatin chemotherapy alone for advanced squamous NSCLC patients from the perspective of the Chinese healthcare system.</p><p><strong>Patients and methods: </strong>A partitioned survival model based on the survival data of the ASTRUM-004 trial was constructed to assess the cost-effectiveness. The direct medical costs and utilities were derived from published literature and real-world medical institutions. The total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated. Sensitivity analyses and scenario analyses were conducted to assess the robustness of the model.</p><p><strong>Results: </strong>The base-case analysis revealed that serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy provided 0.53 incremental QALYs at an incremental cost of $60,790.77, with an ICER of $114,207.24/QALY. The ICER significantly exceeded the Chinese willingness-to-pay threshold ($37,743.79/QALY). Body weight, the utility value of progression-free survival stage, and the price of serplulimab were the main influencing factors of the ICER. Probabilistic sensitivity analysis revealed that there was no possibility of cost-effectiveness under the current threshold. Scenario analyses revealed that this combination therapy would only be cost-effective if the price of serplulimab fell by at least 80.3%.</p><p><strong>Conclusion: </strong>Compared to nab-paclitaxel plus carboplatin chemotherapy alone, serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy might not be economical for advanced squamous NSCLC patients in China under current pricing conditions. This study suggests that future price reductions for serplulimab could make this therapy more economically viable and provide guidance for drug pricing decisions.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1309-1321"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}