基于价值的护理过敏-免疫学:超越质量调整生命年。

IF 2.6 3区 医学 Q2 ALLERGY
Jason Sanders, Matthew Greenhawt, John Oppenheimer, Aikaterini Anagnostou, Marcus S Shaker
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引用次数: 0

摘要

背景:变态反应/免疫学领域的基于价值的医疗保健必须考虑多种因素,包括成本(直接和间接)、结果和患者体验。目的:我们回顾了定义基于价值的医疗保健的特征,并讨论了考虑质量调整生命年(QALY)以外的成本效益医疗的观点。方法:对文献进行叙述性回顾和综合,以促进对考虑共同决策、健康经济结果和患者体验的卫生保健服务的理解。结果:在解释健康经济评价时,必须仔细考虑患者和家庭的健康和保健经验。健康状态实用程序考虑在风险条件下的健康权衡,并用于通知无数疾病状态的qaly。医疗疗法的成本效益与考虑人群的权衡有关,但如果考虑到具体情况,这些指标可以整体转化为为患者提供卫生保健决策的信息。在食物过敏的情况下,omalizumab在个人层面上可能不具有成本效益(增量成本效益比,573,698美元/QALY),但对于那些效用受损严重的个体,或者如果从家庭单位的角度考虑,从健康经济的角度来看,可能是一种更具吸引力的治疗方法。结论:健康和疾病之间的平衡是这样的:在任何时候,疾病总是多于可治疗的疾病,金钱和时间都只能花一次。因为选择是不可避免的,健康经济分析可以帮助告知临床护理。然而,将人口水平的成本效益转化为个人是具有挑战性的,决策必须针对每个患者和环境进行调整。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Value-based care in allergy-immunology: Beyond the quality-adjusted life year.

Background: Value-based health care in the field of allergy/immunology must be informed by multiple factors, including costs (direct and indirect), outcomes, and the patient experience. Objective: We review features that define value-based health care and discuss a perspective that considers cost-effective care beyond the quality-adjusted life year (QALY). Methods: A narrative review and synthesis of the literature was leveraged to advance an understanding of health-care delivery that considers shared decision-making, health-economic outcomes, and the patient experience. Results: The patient and family experience of health and wellness must be considered carefully when interpreting health-economic evaluations. Health-state utilities consider trade-offs for wellness under conditions of risk and are used to inform QALYs for a myriad of disease states. Cost-effectiveness of medical therapies relates to trade-offs that are considered for populations, but these metrics can be translated holistically to inform health-care decisions for patients if considered contextually. In the case of food allergy, omalizumab would likely not be cost-effective on an individual level (incremental cost-effectiveness ratio, $573,698/QALY), but for those individuals with a high utility impairment, or, if considered from the perspective of a family unit, may be a more attractive therapy from a health-economic point of view. Conclusion: The balance between health and disease is such that there is always more disease than can be treated at any given moment, and both money and time can only be spent once. Because choice is inevitable, health-economic analysis can help inform clinical care. Still, translating population-level cost-effectiveness to individuals is challenging and decisions must be tailored to each patient and context.

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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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