Economic Evaluation of the Pediatric Tele-resuscitation Intervention Pilot Study
Notice bibliographique
Résumé
Background: Pediatric Telemedicine Connecting Hospitals (Peds–TECH), a pediatric tele-resuscitation intervention, was developed in partnership with Niagara Health, Brock University and McMaster Children's Hospital. This network aims to enhance pediatric outcomes for infants and children who present to NH hospitals' emergency departments using telemedicine (TM). Objectives: This study aimed to (i) identify out-of-pocket (OOP) costs and time/productivity losses for parents of pediatric patients seeking care at the emergency department (ED); (ii) calculate financial spending within the Peds-TECH intervention and estimate health resource utilization (HRU) costs; (iii) determine the clinical effectiveness of the Peds-TECH intervention on emergency transfers to a tertiary care hospital, and survival/mortality outcomes; and (iv) estimate an incremental cost effectiveness ratio (ICER) of Peds-TECH intervention compared to usual care (i.e., conventional means of providing resuscitation in ED). Methods: A mixed methods quasi-experimental research design was used for this project that included quantitative and qualitative methods in the economic evaluation. This study used qualitative research in the form of interviews, to explore OOP expenses incurred by parents of pediatric patients treated with the Peds-TECH intervention, and quantitative research when determining costs related to health technology and HRU. The ICER represents the incremental costs (Canadian dollar) relative to the years of life lost (YLL) averted in the intervention compared to usual care. The willingness-to-pay (WTP) threshold of $50,000 was considered to interpret the cost-effectiveness of the Peds-TECH intervention. Results: Qualitative interviews with parents revealed OOP expenses pertinent to personal transportation, food/meal, and time/productivity losses. In terms of OOP costs, the largest category in terms of both overall cost ($435) and response rate (5/5) was travel/parking costs. The next most common response to expenses incurred was the cost of food/meals ($80) with a response rate of 3/5. One participant did report paying for hotel accommodations for one day ($120). The odds ratio (OR) for mortality among cases was 0.498 (95% CI, 0.173, 1.43) compared to controls (i.e., usual care), indicating that the intervention was protective against mortality. An ICER of $64.61 per YLL averted was determined from the CEA, which represents the cost for an additional life-year saved in the intervention group compared to the control. In the deterministic sensitivity analysis, the ICER ranged as low as (- 138.72) and as high as (489.75) per YLL averted. The probabilistic analysis indicated 96.1% probability that Peds-TECH is cost-effective under a $5K WTP threshold, which is much lower than the standard $50K WTP threshold. Conclusion: This study acknowledged gaps surrounding the OOP costs associated with pediatric emergencies in the Niagara Region. The Peds-TECH intervention is considered clinically effective in preventing mortality among pediatric patients compared to usual care. As well, it was determined that the Peds-TECH intervention is highly cost-effective with an ICER of $64.61 per YLL averted. Further research is warranted to assess the long-term costs and health outcomes of pediatric patients undergoing the Peds-TECH intervention.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,037 | 0,058 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,004 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».