从英国国家医疗服务体系的角度看数字同意与纸质同意:微观成本分析。

IF 2 Q2 ECONOMICS
Rachel Houten, Mohammad Iqbal Hussain, Antony P Martin, Nick Ainsworth, Claudia Lameirinhas, Alexander W Coombs, Simon Toh, Christopher Rao, Edward St John
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引用次数: 0

摘要

背景:纸质同意书可能会出现信息缺失、错误和患者理解能力不足等问题。数字化同意书解决了其中一些局限性。然而,为了解与采用数字化同意程序相关的相对成本和后果而进行的研究还很有限。本研究旨在比较英国国民健康服务系统(NHS)临床实践中数字同意路径与纸质同意路径的相对成本:方法:从英国国家医疗服务体系的角度开展了一项微观成本研究。多方利益相关者的参与有助于了解不同科室和医院环境下纸质同意书路径的差异。进行了敏感性分析以确定关键的成本驱动因素,并通过情景分析探讨了同意时间和医院数字化准备程度的影响。此外,还考虑了数字化同意的潜在利弊,如与同意相关的诉讼可能产生的影响:结果:如果使用纸质同意书,每份同意书的成本大约要高出 0.90 英镑。订购或打印纸质同意书,以及将同意书运送到仓库再送回诊所,这些都是数字化同意书所不需要的流程步骤。敏感性和情景分析表明,会诊时间对两种途径的相对成本影响最大。每避免一起诉讼索赔,平均可节省 201,590 英镑:结论:数字化同意可为国家医疗服务体系节约成本。建议在手术当天提前对择期手术进行同意,在这种情况下使用数字化同意书可节省最大成本。据估计,会诊持续时间对两种途径的相对成本影响最大,这应该成为进一步调查的重点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Digital Versus Paper-Based Consent from the UK NHS Perspective: A Micro-costing Analysis.

Background: The paper-based consent pathway can be associated with missing information, error, and inadequate patient comprehension. Digital consent addresses some of these limitations. However, limited research has been conducted to understand relative costs and consequences associated with adopting digital consent pathways. The aim of this study was to compare the relative costs of digital consent pathways with paper-based consent pathways in UK National Health Service (NHS) clinical practice.

Method: A micro-costing study was conducted from the UK NHS perspective. Multi-stakeholder involvement contributed to understanding how the paper-based consent pathway varies by department and hospital setting. Sensitivity analyses were conducted to identify the key cost drivers and scenario analyses explored the effect of consent timing and hospital digital readiness. Potential advantages and disadvantages of digital consent were also considered, such as possible impacts associated with consent-related litigation.

Results: The cost per consent episode is approximately £0.90 more expensive when completed on paper. The ordering or printing of paper consent forms, and the transportation of forms to storage and back to clinic are process steps that would not be necessary with digital consent. Sensitivity and scenario analyses indicated consultation duration had the greatest impact on the relative costs of both pathways. Per litigation claim prevented, an average of £201,590 could be saved.

Conclusions: Digital consent is potentially cost saving for the NHS. Consent for elective procedures is recommended in advance of the day of surgery, and digital consent used in this scenario demonstrated the greatest savings. Consultation duration was estimated to have the greatest impact on the relative costs of both pathways, which should be a focus of further investigation.

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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
64
审稿时长
8 weeks
期刊介绍: PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.
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