Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan

• Kinoshita, Takahiro

• Moriwaki, Kensuke

• Hanaki, Nao

• Kitamura, Tetsuhisa

• Yamakawa, Kazuma

• Fukuda, Takashi

• Hunink, Myriam G.M.

• Fujimi, Satoshi

抄録

Kinoshita, T., Moriwaki, K., Hanaki, N. et al. Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan. World J Emerg Surg 16, 2 (2021). https://doi.org/10.1186/s13017-020-00344-x

Background: Hybrid emergency room (ER) systems, consisting of an angiography-computed tomography (CT) machine in a trauma resuscitation room, are reported to be effective for reducing death from exsanguination in trauma patients. We aimed to investigate the cost-effectiveness of a hybrid ER system in severe trauma patients without severe traumatic brain injury (TBI). Methods: We conducted a cost-utility analysis comparing the hybrid ER system to the conventional ER system from the perspective of the third-party healthcare payer in Japan. A short-term decision tree and a long-term Markov model using a lifetime time horizon were constructed to estimate quality-adjusted life years (QALYs) and associated lifetime healthcare costs. Short-term mortality and healthcare costs were derived from medical records and claims data in a tertiary care hospital with a hybrid ER. Long-term mortality and utilities were extrapolated from the literature. The willingness-to-pay threshold was set at $47,619 per QALY gained and the discount rate was 2%. Deterministic and probabilistic sensitivity analyses were conducted. Results: The hybrid ER system was associated with a gain of 1.03 QALYs and an increment of $33,591 lifetime costs compared to the conventional ER system, resulting in an ICER of $32,522 per QALY gained. The ICER was lower than the willingness-to-pay threshold if the odds ratio of 28-day mortality was < 0.66. Probabilistic sensitivity analysis indicated that the hybrid ER system was cost-effective with a 79.3% probability. Conclusion: The present study suggested that the hybrid ER system is a likely cost-effective strategy for treating severe trauma patients without severe TBI.

収録刊行物

• World Journal of Emergency Surgery

  World Journal of Emergency Surgery 16 2-, 2021-01-07

  BioMed Central Ltd

キーワード

• HERS
• ICER
• Markov model
• QALY
• Utility

詳細情報

• CRID: 1050581168901640320
• NII論文ID: 120006955528
• ISSN: 17497922
• HANDLE: 11094/78363
• 本文言語コード: en
• 資料種別: journal article
• データソース種別:
  • IRDB
  • CiNii Articles