基于真实世界数据的CRRT临床应用评价

Evaluation of CRRT Clinical Application Based on Real World Data

目的通过真实世界数据研究方法对连续性肾脏替代治疗(Continuous Renal Replacement Therapy,CRRT)设备进行临床应用评价,以此构建一套有效的CRRT评价体系。方法通过收集整理CRRT设备单机购置成本、住院治疗费用、CRRT治疗前后患者的治疗指标,将代表治疗效果的重点治疗指标量化,用单次治疗费用除以治疗指标评价分值,得到患者治疗成本-效果比。比较两组机型的成本-效果比,讨论两组机型的设备治疗效率。结果经统计,机型B的单机经济效益高于机型A(0.77 vs.0.44);机型B的单位购置成本的治疗效果高于机型A(3.96 vs.3.45);机型A、B在单台设备购置成本及治疗期间使用耗材的成本大致相同(26.5万元/台vs.29.6万元/台,1.84千元/台vs.1.85千元/台);机型A的患者治疗成本高于机型B(2.12万元vs.1.99万元),机型B的成本-效果比高于机型A(2.32 vs.1.69)。在机型A的患者治疗成本高于机型B的情况下,机型B的单机经济效益、治疗效果高、治疗效率均高于机型A。结论使用正确的基于真实世界数据的医疗设备临床应用评价方法,不仅能够对医疗设备进行设备治疗效率层次区分,对医疗机构临床医疗设备的使用行为进行规范,还能够为临床的设备机型选择提供参考,为医疗机构医疗设备采购价格谈判提供数据支撑。

Objective To build an effective continuous renal replacement therapy(CRRT)evaluation system through real world data research method of CRRT devices for clinical application of evaluation.Methods By collecting and sorting out the purchase cost of single CRRT equipment,hospitalization expenses,and treatment indicators of patients before and after CRRT treatment,and the key treatment indicators representing the treatment effect were quantified.The cost-effect ratio of patients was obtained by dividing the single treatment cost by the evaluation score of treatment indicators.The cost-effect ratio of the two groups of models was compared,and the treatment efficiency of the two groups of models was discussed.Results According to statistics,the single machine economic benefit of model B was higher than that of model A(0.77 vs.0.44).The unit acquisition cost of model B was more effective than model A(3.96 vs.3.45).The purchase cost of single equipment and the cost of consumables used during treatment for model A and B were approximately the same(265000 yuan/set vs.296000 yuan/set,1840 yuan/set vs.1850 yuan/set).The treatment cost of model A was higher than that of model B(21200 yuan vs.19900 yuan),and the cost-effect ratio of model B was higher than that of model A(2.32 vs.1.69).In the case that the treatment cost of model A was higher than that of model B,model B single economic benefits,high curative effect,treatment efficiency were higher than model A.Conclusion The correct evaluation method of clinical application of medical equipment based on real world data can not only distinguish the level of equipment treatment efficiency of medical equipment,so as to regulate the use behavior of clinical medical equipment in medical institutions,but also can provide reference for the selection of clinical equipment models and provide data support for the purchase price negotiation of medical equipment in medical institutions.