英国单纯疱疹病毒脑炎早期治疗与延迟治疗的卫生经济影响

Sylviane Defres, Patricia Navvuga, Hayley E Hardwick, Ava Easton, Benedict Michael, Rachel Kneen, Michael Griffiths, Antonieta Medina-Lara, Tom Solomon, ENCEPH UK study group
{"title":"英国单纯疱疹病毒脑炎早期治疗与延迟治疗的卫生经济影响","authors":"Sylviane Defres, Patricia Navvuga, Hayley E Hardwick, Ava Easton, Benedict Michael, Rachel Kneen, Michael Griffiths, Antonieta Medina-Lara, Tom Solomon, ENCEPH UK study group","doi":"10.1101/2024.02.14.24302706","DOIUrl":null,"url":null,"abstract":"Objective: Thanks to the introduction of recent national guidelines for treating herpes simplex virus (HSV) encephalitis health outcomes have improved. This paper evaluates the costs and the health-related quality of life implications of these guidelines. Design and setting: A sub-analysis of data from a prospective, multi-centre, observational cohort ENCEPH-UK study conducted across 29 hospitals in the UK from 2012 to 2015. Study participants: Data for patients aged ≥16 years with a confirmed HSV encephalitis diagnosis admitted for treatment with aciclovir were collected at discharge, 3 and 12 months. Primary and secondary outcome measures: Patient health outcomes were measured by the Glasgow outcome score (GOS), modified ranking score (mRS), and the EuroQoL; health care costs were estimated per patient at discharge from hospital and at 12 months follow-up. In addition, Quality Adjusted Life years (QALYs) were calculated from the EQ-5D utility scores. Cost-utility analysis was performed using the NHS and Social Scare perspective. Results: A total of 49 patients were included, 35 treated within 48 hours ″early″ (median [IQR] 8.25 [3.7-20.5]) and 14 treated after 48 hours (median [IQR] 93.9 [66.7 - 100.1]). At discharge, 30 (86%) in the early treatment group had a good mRS outcome score (0-3) compared to 4 (29%) in the delayed group. EQ-5D-3L utility value at discharge was significantly higher for early treatment (0.609 vs 0.221, p<0.000). After adjusting for age and symptom duration at admission, early treatment incurred a lower average cost at discharge, £23,086 (95% CI: £15,186 to £30,987) vs £42,405 (95% CI: £25,457 to £59,354) [p<0.04]. A -£20,218 (95% CI: -£52,173 to £11,783) cost difference was observed at 12-month follow-up post discharge. Conclusions: This study suggests that early treatment may be associated with better health outcomes and reduced patient healthcare costs, with a potential for savings to the NHS with faster treatment.","PeriodicalId":501072,"journal":{"name":"medRxiv - Health Economics","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Health economic impact of early versus delayed treatment of herpes simplex virus encephalitis in the UK\",\"authors\":\"Sylviane Defres, Patricia Navvuga, Hayley E Hardwick, Ava Easton, Benedict Michael, Rachel Kneen, Michael Griffiths, Antonieta Medina-Lara, Tom Solomon, ENCEPH UK study group\",\"doi\":\"10.1101/2024.02.14.24302706\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: Thanks to the introduction of recent national guidelines for treating herpes simplex virus (HSV) encephalitis health outcomes have improved. This paper evaluates the costs and the health-related quality of life implications of these guidelines. Design and setting: A sub-analysis of data from a prospective, multi-centre, observational cohort ENCEPH-UK study conducted across 29 hospitals in the UK from 2012 to 2015. Study participants: Data for patients aged ≥16 years with a confirmed HSV encephalitis diagnosis admitted for treatment with aciclovir were collected at discharge, 3 and 12 months. Primary and secondary outcome measures: Patient health outcomes were measured by the Glasgow outcome score (GOS), modified ranking score (mRS), and the EuroQoL; health care costs were estimated per patient at discharge from hospital and at 12 months follow-up. In addition, Quality Adjusted Life years (QALYs) were calculated from the EQ-5D utility scores. Cost-utility analysis was performed using the NHS and Social Scare perspective. Results: A total of 49 patients were included, 35 treated within 48 hours ″early″ (median [IQR] 8.25 [3.7-20.5]) and 14 treated after 48 hours (median [IQR] 93.9 [66.7 - 100.1]). At discharge, 30 (86%) in the early treatment group had a good mRS outcome score (0-3) compared to 4 (29%) in the delayed group. EQ-5D-3L utility value at discharge was significantly higher for early treatment (0.609 vs 0.221, p<0.000). After adjusting for age and symptom duration at admission, early treatment incurred a lower average cost at discharge, £23,086 (95% CI: £15,186 to £30,987) vs £42,405 (95% CI: £25,457 to £59,354) [p<0.04]. A -£20,218 (95% CI: -£52,173 to £11,783) cost difference was observed at 12-month follow-up post discharge. Conclusions: This study suggests that early treatment may be associated with better health outcomes and reduced patient healthcare costs, with a potential for savings to the NHS with faster treatment.\",\"PeriodicalId\":501072,\"journal\":{\"name\":\"medRxiv - Health Economics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"medRxiv - Health Economics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1101/2024.02.14.24302706\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"medRxiv - Health Economics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1101/2024.02.14.24302706","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

目的:由于最近出台了治疗单纯疱疹病毒(HSV)脑炎的国家指导方针,健康状况得到了改善。本文评估了这些指南的成本和与健康相关的生活质量影响。设计与环境:对 2012 年至 2015 年期间在英国 29 家医院开展的前瞻性、多中心、观察性队列 ENCEPH-UK 研究的数据进行子分析。研究参与者:收集年龄≥16岁、确诊为HSV脑炎并接受阿昔洛韦治疗的患者在出院、3个月和12个月时的数据。主要和次要结果测量:通过格拉斯哥结果评分(GOS)、改良等级评分(mRS)和EuroQoL衡量患者的健康状况;估算每位患者出院时和随访12个月时的医疗费用。此外,还根据 EQ-5D 实用性评分计算了质量调整生命年(QALYs)。成本效用分析采用了国家医疗服务体系和社会关怀的视角。结果共纳入 49 名患者,其中 35 人在 48 小时内 "早期 "接受治疗(中位数[IQR] 8.25 [3.7-20.5]),14 人在 48 小时后接受治疗(中位数[IQR] 93.9 [66.7 - 100.1])。出院时,早期治疗组有 30 人(86%)的 mRS 结果评分为良好(0-3 分),而延迟治疗组只有 4 人(29%)。早期治疗组患者出院时的 EQ-5D-3L 实用价值明显更高(0.609 vs 0.221,p<0.000)。在对入院时的年龄和症状持续时间进行调整后,早期治疗在出院时产生的平均费用较低,为 23,086 英镑(95% CI:15,186 英镑至 30,987 英镑) vs 42,405 英镑(95% CI:25,457 英镑至 59,354 英镑)[p<0.04]。在出院后 12 个月的随访中,观察到了-20,218 英镑(95% CI:-52,173 英镑至 11,783 英镑)的成本差异。结论:这项研究表明,早期治疗可能会带来更好的健康结果,并降低患者的医疗费用,而且如果治疗速度更快,还有可能为国家医疗服务体系节省开支。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Health economic impact of early versus delayed treatment of herpes simplex virus encephalitis in the UK
Objective: Thanks to the introduction of recent national guidelines for treating herpes simplex virus (HSV) encephalitis health outcomes have improved. This paper evaluates the costs and the health-related quality of life implications of these guidelines. Design and setting: A sub-analysis of data from a prospective, multi-centre, observational cohort ENCEPH-UK study conducted across 29 hospitals in the UK from 2012 to 2015. Study participants: Data for patients aged ≥16 years with a confirmed HSV encephalitis diagnosis admitted for treatment with aciclovir were collected at discharge, 3 and 12 months. Primary and secondary outcome measures: Patient health outcomes were measured by the Glasgow outcome score (GOS), modified ranking score (mRS), and the EuroQoL; health care costs were estimated per patient at discharge from hospital and at 12 months follow-up. In addition, Quality Adjusted Life years (QALYs) were calculated from the EQ-5D utility scores. Cost-utility analysis was performed using the NHS and Social Scare perspective. Results: A total of 49 patients were included, 35 treated within 48 hours ″early″ (median [IQR] 8.25 [3.7-20.5]) and 14 treated after 48 hours (median [IQR] 93.9 [66.7 - 100.1]). At discharge, 30 (86%) in the early treatment group had a good mRS outcome score (0-3) compared to 4 (29%) in the delayed group. EQ-5D-3L utility value at discharge was significantly higher for early treatment (0.609 vs 0.221, p<0.000). After adjusting for age and symptom duration at admission, early treatment incurred a lower average cost at discharge, £23,086 (95% CI: £15,186 to £30,987) vs £42,405 (95% CI: £25,457 to £59,354) [p<0.04]. A -£20,218 (95% CI: -£52,173 to £11,783) cost difference was observed at 12-month follow-up post discharge. Conclusions: This study suggests that early treatment may be associated with better health outcomes and reduced patient healthcare costs, with a potential for savings to the NHS with faster treatment.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信