德国老年患者术后认知功能障碍(POCD)后年度长期护理费用的基于模型的估计

M. Pietzsch, S. Weber, G. Winterer, Florian Lammers-Lietz, F. Borchers, D. Hadzidiakos, F. Yürek, C. Spies, Jochen Kruppa, Sophie K. Piper, G. Winterer, Jochen Kruppa, Sophie K. Piper
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引用次数: 2

摘要

急性术后谵妄(POD)和长期术后认知功能障碍(POCD)是常见的,并与死亡率、对护理的依赖性和住院率增加有关。德国长期护理保险的POCD相关成本负担表明了风险适应治疗计划的潜在节约潜力。到目前为止,尚未评估或公布全面的估计数。设计了一种基于模型的成本分析来估计长期护理保险中与POCD相关的成本。住院手术和程序(OPS代码)的综合分析是病例数计算的基础,然后将其用作实际成本模型的输入。POCD发病率来自BioCog研究。进行了各种敏感性分析,以评估模型结果的不确定性。根据我们分析的基本情况,德国长期护理保险中与POCD相关的年度总成本约为16亿欧元。所有POCD病例的年度总费用取决于手术数量、发病率、其他假设和不确定的输入参数。即使在成本模型的保守情况下,长期护理保险的财务负担也是巨大的。结果的可变性源于不确定的假设、POCD发病率以及正在接受手术的不确定患者人数,因此有患POCD的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Model-Based Estimation of Annual Long-Term Care Costs in Germany Following Post-Operative Cognitive Dysfunction (POCD) in Elderly Patients
Acute post-operative delirium (POD) and long-term post-operative cognitive dysfunction (POCD) are frequent and associated with increased mortality, dependency on care giving and institutionalization rates. The POCD-related cost burden on the German long-term care insurance provides an indication for the savings potential from risk-adapted treatment schemes. Comprehensive estimates have not been assessed or published so far. A model-based cost-analysis was designed to estimate POCD-related costs in the long-term care insurance. Comprehensive analysis of inpatient operations and procedures (OPS-codes) served as the base for case number calculations, which were then used as input to the actual cost model. POCD-incidence rates were obtained from the BioCog study. Various sensitivity analyses were performed to assess uncertainty of the model results. Total POCD related annual costs in the German long-term care insurance account for approximately 1.6 billion EUR according to the base case of our analysis. Total annual costs for all POCD cases depend on surgery numbers, incidence rates, other assumptions, and uncertain input parameters. The financial burden to the long-term care insurance is substantial, even in a conservative scenario of the cost model. Variability of results stems from uncertain assumptions, POCD-incidence rates and from uncertain patient numbers who are undergoing surgery and are therefore at risk to develop POCD.
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