دورية أكاديمية
Economic impact of limb-salvage strategies in chronic limb-threatening ischaemia: modelling and budget impact study based on national registry data.
| العنوان: | Economic impact of limb-salvage strategies in chronic limb-threatening ischaemia: modelling and budget impact study based on national registry data. |
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| المؤلفون: | Saratzis A; Department of Cardiovascular Sciences, National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC), Leicester, UK., Zayed H; School of Cardiovascular Medicine and Metabolic Sciences, King's College London, London, UK.; Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK., Buylova A; National Health Service Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit, Stoke on Trent, UK., Rawlinson W; National Health Service Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit, Stoke on Trent, UK., Veliu G; Abbott Health Economics & Reimbursement Department, Zaventem, Belgium., Siebert M; Abbott Health Economics & Reimbursement Department, Zaventem, Belgium. |
| المصدر: | BJS open [BJS Open] 2024 Sep 03; Vol. 8 (5). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 101722685 Publication Model: Print Cited Medium: Internet ISSN: 2474-9842 (Electronic) Linking ISSN: 24749842 NLM ISO Abbreviation: BJS Open Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2021- : [Oxford] : Oxford University Press Original Publication: [Chichester, West Sussex, England] : John Wiley & Sons Ltd., [2017]- |
| مواضيع طبية MeSH: | Registries* , Amputation, Surgical*/economics , Amputation, Surgical*/statistics & numerical data , Limb Salvage*/economics , State Medicine*/economics, Humans ; England ; Wales ; Chronic Limb-Threatening Ischemia/surgery ; Chronic Limb-Threatening Ischemia/economics ; Budgets ; Lower Extremity/blood supply ; Lower Extremity/surgery ; Male ; Ischemia/economics ; Ischemia/surgery ; Female ; Vascular Surgical Procedures/economics ; Models, Economic ; Chronic Disease |
| مستخلص: | Background: Missed opportunities to reduce numbers of primary major lower-limb amputation and increase limb-salvage procedures when treating chronic limb-threatening ischaemia have previously been identified in the literature. However, the potential economic savings for healthcare providers when salvaging a chronic limb-threatening ischaemia-affected limb have not been well documented. Methods: A model using National Health Service healthcare usage and cost data for 1.6 million individuals and averaged numbers of primary surgical procedures for chronic limb-threatening ischaemia from England and Wales in 2019-2021 was created to perform a budget impact analysis. Two scenarios were tested: the averaged national rates of major lower-limb amputation (above the ankle joint), angioplasty, open bypass surgery or arterial endarterectomy in the National Vascular Registry (current scenario); and revascularization rates adjusted based on the lowest amputation rate reported by the National Vascular Registry at the time of the study (hypothetical scenario). The primary outcome was the net impact on costs to the National Health Service over 12 months after the index procedure. Results: In the current scenario, the proportions of different index procedures were 10% for lower-limb major amputation, 55% for angioplasty, 25% for open bypass surgery and 10% for arterial endarterectomy. In the hypothetical scenario, the procedure rates were 3% for major lower-limb amputation, 59% for angioplasty, 27% for open bypass surgery and 11% for arterial endarterectomy. For 16 025 index chronic limb-threatening ischaemia procedures, the total care cost in the current scenario was €243 924 927. In the hypothetical scenario, costs would be reduced for index procedures (-€10 013 814), community care (-€633 943) and major cardiovascular events (-€383 407), and increased for primary care (€59 827), outpatient appointments (€120 050) and subsequent chronic limb-threatening ischaemia-related surgery (€1 179 107). The net saving to the National Health Service would be €9 645 259. Conclusion: A shift away from primary major lower-limb amputation towards revascularization could lead to substantial savings for the National Health Service without major cost increases later in the care pathway, indicating that care decisions taken in hospitals have wider benefits. (© Crown copyright 2024.) |
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| معلومات مُعتمدة: | Abbott |
| تواريخ الأحداث: | Date Created: 20240918 Date Completed: 20240918 Latest Revision: 20240921 |
| رمز التحديث: | 20240921 |
| مُعرف محوري في PubMed: | PMC11408877 |
| DOI: | 10.1093/bjsopen/zrae099 |
| PMID: | 39291605 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2474-9842 |
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| DOI: | 10.1093/bjsopen/zrae099 |