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Protocol Implementation for Normothermia in Surgery Settings in Italy: Budget-Impact Analysis

机译:意大利手术环境中常温的协议实施:预算影响分析

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Introduction:Hypothermia is a well-known risk of the perioperative period and considered a preventable effect of anesthesia care. Nevertheless, it is not fully controlled, causing a number of adverse outcomes following surgical operations and thus increasing length of stay in hospital and treatment costs. The aim of this study was to assess the budget impact (BI) of the implementation of proactive strategies to prevent inadvertent perioperative hypothermia (IPH) in surgical patients in Italy, as recommended by international guidelines and by a good clinical practice (GCP) guideline of the Italian Society of Anesthesia, Analgesia, Reanimation, and Intensive Care.Methods:BI was calculated over a 3-year period from the perspective of the Italian National Health Service (NHS). Model inputs were extracted from national literature when available and otherwise from international sources. The reference analytic model was based on the cost-effectiveness analysis of the National Institute for Health and Care Excellence clinical guidance 65. Estimates were based on assessments made about current malpractice in Italy and on a hypothesis of how future practice might change by implementing the GCP. Model output included overall BI results, variations in the number of warmed patients, medical-device average costs and use of mix.Results:The base-case estimate quantified a decrease of 35% in extra days of hospital stay due to IPH and a net BI of -€60.92 million.Conclusion:Increasing protocol adoption for preventing IPH would lead to both clinical advantages and significant savings for the NHS. Its large diffusion in Italian hospitals is thus desirable.? 2020 Monzani et al.
机译:介绍:体温过低是围手术期的众所周知的风险,被认为是麻醉护理的可预防效果。然而,它没有完全控制,造成手术操作后的许多不利结果,从而增加了医院和治疗成本的逗留时间。本研究的目的是评估在意大利的外科患者中,根据国际准则和良好的临床实践(GCP)指南,评估在意大利的外科患者中实施积极主动策略的预算影响(BI)。意大利麻醉,镇痛,复活和密集护理学会。方法:BI从意大利国家卫生服务(NHS)的角度来计算3年的时间。当可用时从国家文学中提取模型投入,否则来自国际来源。参考分析模型是基于国家健康和护理研究所的成本效益分析临床指导65.估计是根据意大利当前弊端的评估,并通过实施GCP的未来做法如何变化的假设。模型输出包括整体BI结果,温暖患者数量的变化,医疗器械平均成本和混合的使用。结果:由于IPH和网,额外天的基本情况估计量化了35%的减少BI为60.92亿欧元。结论:增加预防IPH的议定书通过将导致NHS的临床优势和大量节省。因此,它在意大利医院的大扩散是理想的。 2020 Monzani等。

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