Název:	Cost-effectiveness of extracorporeal membrane oxygenation in resuscitation of patients with refractory cardiac arrest
Autoři:	Burišková, Klára Rogalewicz, Vladimir Ošťádal, Petr
Citace zdrojového dokumentu:	E+M. Ekonomie a Management = Economics and Management. 2019, roč. 22, č. 1, s. 161-172.
Datum vydání:	2019
Nakladatel:	Technická univerzita v Liberci
Typ dokumentu:	článek article
URI:	http://hdl.handle.net/11025/6335
ISSN:	2336-5604 (Online) 1212-3609 (Print)
Klíčová slova:	efektivita nákladů;užitečnost nákladů;mimotělní kardiopulmonální resuscitace;refrakterní srdeční zástava
Klíčová slova v dalším jazyce:	cost-effectiveness;cost-utility;extracorporeal cardiopulmonary resuscitation;refractory cardiac arrest
Abstrakt v dalším jazyce:	Extracorporeal cardiopulmonary resuscitation (ECPR) has been recently introduced as a therapeutic option for refractory cardiac arrest. Despite growing evidence demonstrating improved survival rate, a number of questions remains unanswered and data on cost-effectiveness are still insuffi cient. The paper is based on a retrospective observational comparative study of authentic clinical data from patient records. Incremental cost-effectiveness and cost-utility analyses were performed from health care provider’s perspective. Sixteen patients undergoing ECPR were included into the analysis and their data were compared with 35 subjects with conventional CPR for refractory cardiac arrest. In the ECPR group eight out of sixteen patients were weaned from ECMO, four of them with good neurological outcomes (CPC 1-2); three patients survived one year with CPC 1-2, one patient survived one year with severe neurological dysfunction (CPC 3), and one patient with persisting coma (CPC 4). In comparison, in the non-ECPR group all patients died within 24 hours. In the ECPR group, the average annual costs per patient reached CZK 885,044 (Levitronix Centrimag), and CZK 788,432 (Cardiohelp) (the 2013 price level). CUA revealed 3,961,970 CZK/ QALY with Cardiohelp, and 4,447,457 CZK/QALY with Levitronix. However, if only patients with CPC 1-2 were included into the analysis, the cost-utility ratio decreased below the unoffi cial Czech cost-effectiveness threshold. Our data indicate that ECPR for refractory cardiac arrest may be cost-effective despite high costs per individual patients, especially if we were able to better select patients for this intervention based on a reliable prediction of the neurological outcome.
Práva:	CC BY-NC 4.0
Vyskytuje se v kolekcích:	Číslo 2 (2019) Číslo 2 (2019)

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