COST-EFFECTIVENESS ANALYSIS OF THE OTTAWA ANKLE RULES

被引：74

作者：

ANIS, AH ^{[1
]}

STIELL, JG ^{[1
]}

STEWART, DG ^{[1
]}

LAUPACIS, A ^{[1
]}

机构：

[1] UNIV BRITISH COLUMBIA,DEPT HLTH CARE & EPIDEMIOL,VANCOUVER,BC V6T 1W5,CANADA

来源：

ANNALS OF EMERGENCY MEDICINE | 1995年 / 26卷 / 04期

关键词：

D O I：

10.1016/S0196-0644(95)70108-7

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To conduct an incremental cost-effectiveness analysis of implementation of the Ottawa Ankle Rules in emergency departments in the United Stales and Canada. Design: A decision analytic approach to technology assessment. Clinical decision rules that allow physicians to be more selective in their use of radiography were compared with current practice in a decision analytic model. Setting: A university hospital adult ED. Participants: ED physicians instructed in the use of the Ottawa Ankle Rules for adult patients with ankle injury. Results: Radiography, waiting time, lost productivity, and medicolegal costs were calculated. In the United States, the savings varied between U5$614,226 and US$3,145,910 per 100,000 patients, depending on the charge rate for radiography. In Ontario, Canada, the total savings were CAN$730,145 per 100,000 patients. One- and two-way sensitivity analyses that varied the rate of missed fractures, cost of radiography, probability of lawsuits, and cost of lawsuits did not change the results substantially. Conclusion: Implementation of the Ottawa Ankle Rules would result in significant savings of health care dollars despite the cost of missed fractures including litigation costs.

引用

页码：422 / 428

页数：7

共 23 条

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