手术减重治疗2型糖尿病的成本效果评估:寿命分析模型

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目的在Ⅰ、Ⅱ级肥胖的新近诊断2型糖尿病患者中评估手术减重相对于常规疗法的成本效果。研究设计和方法本试验基于试验内的成本效果分析。比较两个干预组的终生花费和质量调整生命年(QALYs)。根据试验期的资源利用来推断干预成本。试验观察发现2年中两个干预组的糖尿病缓解比例是相同的。2型糖尿病患者医疗保健所需费用和结果变量需要根据已发表文献求出QALYs。从医疗保健体系角度出发。成本和成果每年折扣率为3%。花费情况根据2006年澳元汇率。(汇率:1澳元=0.74美元)。结果手术治疗患者糖尿病缓解的年数是11.4年,而常规疗法是2.1年。在这些患者剩余时间里,根据折现的质量调整生命年,手术疗法和常规疗法的患者分别可以生存15.7年和14.5年。每位手术患者平均折扣下来终生花费是98,900澳元,而每位常规疗法患者是101,400澳元。相对于常规疗法,每位手术减重患者平均可节约医疗保健费用2,400澳元并可额外增加1.2个质量调整生命年。结论在澳大利亚,手术减重对于治疗Ⅰ、Ⅱ级肥胖的新近诊断2型糖尿病患者是一种主要的干预措施(它不仅节约医疗保健费用而且创造了保健福利)。 OBJECTIVE: To evaluate the cost-effectiveness of surgical weight loss versus conventional therapies in newly diagnosed type 2 diabetic patients with grade I and II obesity. Study Design and Methodology This test is based on cost-effectiveness analysis within the trial. The lifetime costs and QALYs were compared between the two intervention groups. According to the use of resources during the trial to infer the cost of intervention. Experimental observation found that 2 years in the two intervention groups diabetes relief ratio is the same. Costs and Outcomes for Healthcare in Type 2 Diabetes Patients QALYs need to be based on published literature. From the health care system point of view. The annual discount rate for costs and results is 3%. Spending is based on the 2006 Australian dollar exchange rate. (Exchange rate: 1 Australian dollar = 0.74 US dollars). Results The number of patients who underwent surgery for remission was 11.4 years, compared with 2.1 years for conventional therapy. During the remainder of these patients, patients who adjusted for life based on the quality of the discounts, surgery, and conventional therapies survived 15.7 years and 14.5 years, respectively. The average lifetime cost for each surgical patient is $ 98,900, compared to $ 101,400 per regular therapy patient. Compared to conventional therapies, each surgical weight-loss patient can save an average of $ 2,400 on healthcare costs and an additional 1.2 quality-adjusted life years. Conclusions In Australia, surgical weight loss is a major intervention for newly diagnosed type 2 diabetes patients who are in stage I and II obesity (which not only saves on health care but also creates health benefits).
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