tailieunhanh - Báo cáo y học: "Insomnia - treatment pathways, costs and quality of life"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Insomnia - treatment pathways, costs and quality of life. | Scott et al. Cost Effectiveness and Resource Allocation 2011 9 10 http content 9 1 10 COST EFFECTIVENESS AND RESOURCE ALLOCATION RESEARCH Open Access Insomnia - treatment pathways costs and quality of life Guy W Scott 1 Helen M Scott2 Karyn M O Keeffe3 and Philippa H Gander3 Abstract Background Insomnia is perhaps the most common sleep disorder in the general population and is characterised by a range of complaints around difficulties in initiating and maintaining sleep together with impaired waking function. There is little quantitative information on treatment pathways costs and outcomes. The aims of this New Zealand study were to determine from which healthcare practitioners patients with insomnia sought treatment treatment pathways followed the net costs of treatment and the quality of life improvements obtained. Methods The study was retrospective and prevalence based and was both cost effectiveness CEA and a cost utility CUA analysis. Micro costing techniques were used and a societal analytic perspective was adopted. A deterministic decision tree model was used to estimate base case values and a stochastic version with Monte Carlo simulation was used to perform sensitivity analysis. A probability and cost were attached to each event which enabled the costs for the treatment pathways and average treatment cost to be calculated. The inputs to the model were prevalence event probabilities resource utilisations and unit costs. Direct costs and QALYs gained were evaluated. Results The total net benefit of treating a person with insomnia was 482 the total base case cost of 145 less health costs avoided of 628 . When these results were applied to the total at-risk population in New Zealand additional treatment costs incurred were million costs avoided million and net benefits were million. The incremental net benefit when insomnia was successfully treated was 3 072 per QALY gained. Conclusions The study has brought to light