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首页> 外文期刊>British journal of ophthalmology >Falls and health status in elderly women following first eye cataract surgery: an economic evaluation conducted alongside a randomised controlled trial.
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Falls and health status in elderly women following first eye cataract surgery: an economic evaluation conducted alongside a randomised controlled trial.

机译：首次眼睛白内障手术后老年妇女的跌倒和健康状况：与一项随机对照试验一起进行的经济评估。

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AIM: To evaluate the cost-effectiveness of first eye cataract surgery compared with no surgery from a health service and personal social services perspective. METHODS: An economic evaluation undertaken alongside a randomised controlled trial of first eye cataract surgery in secondary care ophthalmology clinics. A sample of 306 women over 70 years old with bilateral cataracts was randomised to cataract surgery (expedited, approximately four weeks) or control (routine, 12 months wait); 75% of participants had baseline acuity of 6/12 or better. Outcomes included falls and the EuroQol EQ-5D. RESULTS: The operated group cost a mean pounds sterling 2004 (bootstrapped) more than the control group over one year (95% confidence interval (CI), pounds sterling 1363 to pounds sterling 2833) (p<0.001), but experienced on average 0.456 fewer falls, an incremental cost per fall prevented of pounds sterling 4390. The bootstrapped mean gain in quality adjusted life years (QALYs) per patient was 0.056 (95% CI, 0.006 to 0.108) (p<0.001). The incremental cost-utility ratio was pounds sterling 35 704, above the currently accepted UK threshold level of willingness to pay per QALY of pounds sterling 30 000. However, in an analysis modelling costs and benefits over patients' expected lifetime, the incremental cost per QALY was pounds sterling 13 172, under conservative assumptions. CONCLUSIONS: First eye cataract surgery, while cost-ineffective over the trial period, was probably cost-effective over the participants' remaining lifetime.
机译：目的：从健康服务和个人社会服务的角度，评估首次眼白内障手术与不手术相比的成本效益。方法：在二级保健眼科诊所对首次眼白内障手术的随机对照试验进行经济评估。将306名70岁以上患有双侧白内障的妇女随机分为白内障手术（加急手术，约4周）或对照组（常规，等待12个月）; 75％的参与者的基线视力为6/12或更高。结果包括坠落和EuroQol EQ-5D。结果：手术组在一年内的平均英镑成本（自举）高于对照组（95％置信区间（CI），英镑1363英镑至2833英镑）（p <0.001），但平均水平为0.456减少跌倒的次数，防止每次跌倒产生的英镑增加成本4390。每名患者的平均经调整生命周期质量增长（QALYs）为0.056（95％CI，0.006至0.108）（p <0.001）。成本－效用的增量比率为35 704英镑，高于英国目前接受的每QALY支付意愿的阈值水平3万英镑。但是，在对患者预期寿命期间的成本和收益进行建模的分析中，在保守的假设下，QALY为13172英镑。结论：首次眼内白内障手术虽然在试验期间没有成本效益，但在参与者的余生中可能具有成本效益。

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