Increasing doctors' confidence would solve low uptake of prehospital thrombolysis
| Autor: | J A Ellerton |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Emergency Medical Services
medicine.medical_treatment Population Emergency medical services Medicine Humans Thrombolytic Therapy General hospital education Hospital use health care economics and organizations General Environmental Science education.field_of_study business.industry Anistreplase General Engineering General Medicine Thrombolysis medicine.disease Prehospital thrombolysis Local community General Earth and Planetary Sciences Medical emergency Clinical Competence business medicine.drug Research Article |
| Zdroj: | BMJ (Clinical research ed.). 314(7091) |
| ISSN: | 0959-8138 |
| Popis: | OBJECTIVES: To assess the cost effectiveness of community thrombolysis relative to hospital thrombolysis by investigating the extra costs and benefits of a policy of community thrombolysis, then establishing the extra cost per life saved by community thrombolysis. DESIGN: Economic evaluation based on the results of the Grampian region early anistreplase trial. SETTING: 29 rural general practices and one secondary care provider in Grampian, Scotland. SUBJECTS: 311 patients recruited to the Grampian region early anistreplase trial. INTERVENTIONS: Intravenous anistreplase given either by general practitioners or secondary care clinicians. MAIN OUTCOME MEASURES: Survival at 4 years and costs of administration of thrombolysis. RESULTS: Relative to hospital thrombolysis, community thrombolysis gives an additional probability of survival at 4 years of 11% (95% confidence interval 1% to 22%) at an additional cost of 425 pounds per patient. This gives a marginal cost of life saved at 4 years of 3,890 pounds (1,990 pounds to 42,820 pounds). CONCLUSIONS: The cost per life saved by community thrombolysis is modest compared with, for example, the cost of changing the thrombolytic drug used in hospital from streptokinase to alteplase. |
| Databáze: | OpenAIRE |
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