学校综合病虫害管理和空气过滤对哮喘学生的成本效益。

IF 2.6 3区 医学 Q2 ALLERGY
Carmela Socolovsky, Margee Louisias, Saleh Alsulami, Carter R Petty, Michelle Trivedi, Peggy S Lai, Amparito Cunningham, Jonathan Gaffin, Peter Thorne, Brent Coull, Petros Koutrakis, Andrea Baccarelli, Diane J Gold, Gary Adamkiewicz, Perdita Permaul, Tina Banzon, Marissa Hauptman, Lisa M Bartnikas, Sachin Baxi, William J Sheehan, Wanda Phipatanakul, Mihail Samnaliev
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引用次数: 0

摘要

背景:学校环境修复治疗哮喘的成本效益尚不清楚。学校内城哮喘干预研究(SICAS2)是一项随机对照试验,旨在评估学校综合有害生物管理(IPM)和教室高效微粒空气(HEPA)过滤对城市学校哮喘发病率的影响。目的:目的是评估SICAS2的成本效益。方法:我们从社会角度进行了成本-效果分析,比较了四种干预措施:IPM、HEPA、IPM + HEPA和不干预。质量调整生命年(QALY)由EuroQol-5维度-青年和EuroQol-5维度-3水平仪器得出。总成本(2021美元)包括干预成本、儿童缺课影响护理人员生产力的成本和医疗保健利用成本(例如急诊就诊)。评估期以平均随访时间166天为基础。敏感度分析是通过使用高于和低于初始成本基准50%的成本估算来进行的。结果:共纳入154名SICAS2参与者。每位学生的干预费用分别为12.21美元(IPM + HEPA)、7.27美元(IPM)和4.94美元(HEPA)。序列分析显示,IPM + HEPA是最具成本效益的选择,每个QALY的增量成本效益比为19,667美元。敏感性分析显示稳定性,概率估计的变异性不超过10%。结论:IPM + HEPA具有良好的社会价值,反映了低成本和旷课天数的经济影响。这种干预措施可能对城市学校中历史上少数民族和边缘化的儿童有明显的好处,这些儿童不成比例地暴露于空气污染和室内过敏原。SICAS2干预措施可以提供一种具有成本效益的工具,即使在资源最有限的学校中也可以针对差异的近端原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-effectiveness of school integrated pest management and air filtration in students with asthma.

Background: The cost-effectiveness of school environmental remediation in asthma is not known. The School Inner City Asthma Intervention Study (SICAS2) was a randomized controlled trial that assessed school integrated pest management (IPM) and classroom high efficiency particulate air (HEPA) filtration on asthma morbidity in urban schools. Objective: The objective was to evaluate the cost-effectiveness of SICAS2. Methods: We conducted a cost-effectiveness analysis from a societal perspective that compared four interventions: IPM, HEPA, IPM + HEPA, and no intervention. Quality-adjusted life years (QALY) were derived from the EuroQol-5 Dimension-Youth and EuroQol-5 Dimension-3 levels instruments. Total costs (2021 U.S. dollars) included intervention cost, cost of caregiver productivity impacted by child school absenteeism, and health-care utilization costs (e.g., emergency department visits). The evaluation period was based on a mean follow-up time of 166 days. Sensitivity analyses were performed by using cost estimates 50% above and below initial cost benchmarks. Results: A total of 154 SICAS2 participants were included. Intervention costs per student were $12.21 (IPM + HEPA), $7.27 (IPM), and $4.94 (HEPA). Sequential analyses revealed that IPM + HEPA was the most cost-effective option, with an incremental cost-effectiveness ratio of $19,667 per QALY. Sensitivity analyses demonstrated stability, with variability in probability estimates not exceeding 10%. Conclusion: IPM + HEPA demonstrated good value to society, which reflected the low cost and the economic impact of missed school days. This intervention may have a pronounced benefit for historically minoritized and marginalized children in urban schools who are disproportionately exposed to air pollution and indoor allergens. The SICAS2 intervention may offer a cost-effective tool to target proximal causes of disparities even in the most resource-limited schools.

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来源期刊
CiteScore
5.70
自引率
35.70%
发文量
106
审稿时长
6-12 weeks
期刊介绍: Allergy & Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists. The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma. Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.
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