当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN GERIATRICS SOCIETY期刊下所有文献 > Cost-Effectiveness of the 4 Pillars Practice Transformation Program to Improve Vaccination of Adults Aged 65 and Older.

Cost-Effectiveness of the 4 Pillars Practice Transformation Program to Improve Vaccination of Adults Aged 65 and Older.

Abstract：

OBJECTIVES:To estimate the cost-effectiveness of an intervention to increase pneumococcal, influenza, and pertussis-containing vaccine uptake in adults aged 65 and older in primary care practices. DESIGN:Markov decision analysis model, comparing the cost-effectiveness of the 4 Pillars Practice Transformation Program with no intervention. SETTING:Diverse primary care practices in two U.S. cities. PARTICIPANTS:Clinical trial participants aged 65 and older. MEASUREMENTS:Quality-adjusted life years (QALYs), public health outcomes, and costs. Vaccination rates and intervention costs were derived from a randomized controlled cluster trial. Other parameters were derived from the medical literature and Centers for Disease Control and Prevention data. All parameters were individually and simultaneously varied over their distributions. RESULTS:With the intervention program and extrapolating over 10 years, there would be approximately 60,920 fewer influenza cases, 2,031 fewer pertussis cases, and 13,842 fewer pneumococcal illnesses in adults aged 65 and older. Total per-person vaccination and illness costs with the intervention were $23.93 higher than without the intervention, with a concurrent increase in effectiveness of 0.0031 QALYs, or $7,635 per QALY gained. In sensitivity analyses, no individual parameter variation caused the intervention to cost more than $50,000 per QALY gained. CONCLUSIONS:Implementing an intervention based on the 4 Pillars Practice Transformation Program is a cost-effective undertaking in primary care practices for individuals aged 65 and older, with predicted public health benefits.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Smith KJ,Zimmerman RK,Nowalk MP,Lin CJ

doi

10.1111/jgs.14588

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

763-768

issue

4

eissn

0002-8614

issn

1532-5415

journal_volume

65

pub_type

杂志文章,多中心研究,随机对照试验

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