Annalisa Gatto, Margherita Tofanelli, Giorgio Valentinuz, Ludovico Carrino, Simone Zucchini, Egidio Sia, Francesco Uderzo, Vittorio Pietro Achilli, Giancarlo Tirelli
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引用次数: 0
摘要
目的：分析意大利语后耳聋成人单侧人工耳蜗（CI）手术的成本-效果，重点关注直接成本、健康效用指数（HUI）、质量调整生命年（QALY）和增量成本-效果比（ICER）。方法：从意大利医疗保健系统的角度分析，包括术前、手术、住院和术后费用。使用意大利奈梅亨人工耳蜗问卷（I-NCIQ）和安大略省健康公用事业指数标记3 （HUI-3）估计质量aly。采用SAS Institute Inc . Stat View （v5.0.1）软件中的回归模型分析HUI-3评分变化。ICER计算为平均患者一生中每个QALY的增量成本（以欧元/QALY为单位）。结果：CI显著改善I-NCIQ （p < 0.001）和HUI-3评分（p < 0.0001）。手术后的平均预期寿命为21.2岁；降解因子为0.97，终生增益为2.717 QALYs。直接费用为19 467.65欧元。成本效用分析显示，每个QALY为7,165.13欧元，低于30,000欧元/QALY ICER门槛。结论：基于QALY分析，CI手术具有成本效益。虽然成本效益随着年龄的增长而下降，但生活质量和健康效益与年轻患者相当。
Socio-economic impact of cochlear implantation in adults: an Italian study.
Objective: To analyse the cost-effectiveness of unilateral cochlear implant (CI) surgery in Italian adults with post-lingual deafness, focusing on direct costs, Health Utilities Index (HUI), Quality-Adjusted Life Years (QALY), and Incremental Cost-Effectiveness Ratio (ICER).
Methods: The analysis, from the Italian healthcare system perspective, included preoperative, surgical, hospitalisation, and postoperative costs. QALYs were estimated using the Italian Nijmegen Cochlear Implant Questionnaire (I-NCIQ) and Ontario Health Utilities Index Mark 3 (HUI-3). HUI-3 score changes were analysed with regression models in Stat View (v5.0.1, SAS Institute Inc). ICER was calculated as the incremental cost per QALY (in Euros/QALY) over the average patient's lifetime.
Results: CI significantly improved I-NCIQ (p < 0.001) and HUI-3 scores (p < 0.0001). Average life expectancy at surgery was 21.2 years; the degrade factor was 0.97, yielding a lifetime gain of 2.717 QALYs. Direct costs amount to €19,467.65. Cost-utility analysis showed €7,165.13 per QALY, below the €30,000/QALY ICER threshold.
Conclusions: CI surgery is cost-effective based on QALY analysis. Although cost-effectiveness decreases with age, quality of life and health benefits are comparable to younger patients.
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