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首页> 外文期刊>Revista Brasileira de Ortopedia >Cost-effectiveness of surgical treatment for hip fractures among the elderly in Brazil
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Cost-effectiveness of surgical treatment for hip fractures among the elderly in Brazil

机译:巴西老年人髋部骨折手术治疗的成本效益

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Objectives To estimate the cost per quality-adjusted life-year (QALY) focusing on the length of time between trauma and surgery. Methods A retrospective cohort with systematic sampling was conducted among all the patients who were admitted to the study hospital through the Brazilian National Health System (SUS) over a three-year period. Two treatment strategies were compared: early treatment, if the patient was operated up to the fourth day; and late treatment, if this was done after the fourth day. The cost was the direct medical cost from the point of view of SUS, which was gathered from the management system, from the SUS table of procedures, medications and implant material costs (SIGTAP), to account for the costs associated with the hospital, medical fees and implants used. The outcome of usefulness was measured indirectly by means of EuroQOL-5D, which is an instrument used worldwide, and these measurements were transformed into usefulness by means of the standard rules of the Regional Planning and Development Center of Minas Gerais (CEDEPLAR) of 2013. Results The sample included 110 patients: 27 in the early group and 83 in the late group. The confounding variables of age, gender, anesthetic risk (ASA), fracture type and surgery type were controlled for. The samples were shown to be homogenous with regard to these variables. The cost per QALY of the early strategy was R$ 5,129.42 and the cost of the late strategy was R$ 8,444.50. Conclusion The early strategy was highly favorable in relation to the late strategy in this study.
机译:目的评估创伤和手术之间的时间长度,以每质量调整生命年(QALY)的成本进行估算。方法对在三年期间通过巴西国家卫生系统(SUS)入研究医院的所有患者进行回顾性队列研究。比较了两种治疗策略:早期治疗(如果患者在第四天进行手术);如果在第四天之后进行,则应进行后期治疗。从SUS的角度来看,该成本是直接医疗成本,它是从管理系统收集的,是从SUS程序表,药物和植入物材料成本(SIGTAP)来考虑与医院,医疗相关的成本费用和使用的植入物。有用性的结果是通过EuroQOL-5D间接测量的,EuroQOL-5D是一种在全球范围内使用的工具,并且这些测量结果已根据2013年米纳斯吉拉斯州地区计划与发展中心(CEDEPLAR)的标准规则转化为有用性。结果样本包括110例患者:早期组27例,晚期组83例。控制年龄,性别,麻醉风险(ASA),骨折类型和手术类型的混杂变量。样品在这些变量方面显示出均一性。早期策略的每QALY费用为5,129.42雷亚尔,后期策略的每QALY费用为8,444.50雷亚尔。结论与本研究的后期策略相比,早期策略非常有利。

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