Terapötik Girişimlerde Bedel Etkinlik
Özet
Acil tıpta maliyet etkinliği, sınırlı sağlık kaynaklarının en verimli şekilde kullanılmasını ve en iyi sağlık sonuçlarının elde edilmesini amaçlayan temel bir ilkedir. Acil servislerde farklı tanı ve tedavi stratejilerinin maliyet ve faydalarının sistematik olarak karşılaştırılması, hem hasta bakımının kalitesini hem de sağlık sisteminin sürdürülebilirliğini artırır. Maliyet-etkinlik analizi (Cost-effectiveness analysis-CEA), alternatif müdahalelerin maliyetlerini ve sağlık sonuçlarını karşılaştırarak, kaynakların en verimli şekilde tahsis edilmesini sağlar. Ekonomik değerlendirme yöntemleri arasında maliyet-etkinlik analizi (CEA), maliyet-fayda analizi (Cost-Benefit Analysis-CBA) ve maliyet-yararlılık analizi (Cost-Utility Analysis-CUA) yer alır. CEA, genellikle yaşam yılı veya önlenen vaka gibi doğal birimler üzerinden değerlendirme yaparken, CUA kaliteye uyarlanmış yaşam yılı (Quality Adjusted Life Year-QALY) gibi ölçütler kullanır. CBA ise tüm maliyet ve faydaları parasal birimlerle ifade eder. Bu yöntemler, klinik karar alma süreçlerinde ve kaynak tahsisinde yol göstericidir. Acil tıpta maliyet etkinliğini etkileyen faktörler arasında doğrudan tıbbi maliyetler (ilaç, tetkik, personel), dolaylı maliyetler (iş gücü kaybı, üretkenlik kaybı) ve maddi olmayan maliyetler (ağrı, yaşam kalitesinde azalma) bulunur. Etkinliğin ölçülmesinde ise ölüm oranı, morbidite, hastanede kalış süresi ve yaşam kalitesi gibi göstergeler kullanılır. Uygulamada, akılcı ilaç kullanımı, tanısal algoritmalar, erken taburculuk kriterleri ve evde bakım gibi stratejiler, hem maliyetleri azaltmakta hem de hasta sonuçlarını iyileştirmektedir. Ayrıca, triyaj sistemleri, protokoller ve atık yönetimi gibi organizasyonel yaklaşımlar da acil servis işleyişinde maliyet etkinliğini artırmaktadır. Sonuç olarak, acil tıpta maliyet etkinliği analizleri, hem hasta merkezli hem de sürdürülebilir sağlık hizmeti sunumunu destekler. Standartlaştırılmış yöntemlerle ve yerel verilerle desteklenen analizler, sağlık politikası yapıcıları ve klinisyenler için daha doğru kararlar alınmasına katkı sağlar. Özellikle acil servislerde yapılan maliyet-etkinlik çalışmaları, kaynakların en verimli şekilde kullanılmasına ve hasta bakımının optimize edilmesine olanak tanır.
Referanslar
M. April and B. Murray. "Cost‐effectiveness Analysis Appraisal and Application: An Emergency Medicine Perspective." Academic Emergency Medicine, 24 (2017): 754–768. https://doi.org/10.1111/acem.13186.
B. Bassin, N. Haas, Nana Sefa, et al. "Cost-effectiveness of an Emergency Department–Based Intensive Care Unit." JAMA Network Open, 5 (2022). https://doi.org/10.1001/jamanetworkopen.2022.33649.
David D. Kim and A. Basu. "How Does Cost-Effectiveness Analysis Inform Health Care Decisions?." AMA journal of ethics, 23 8 (2021): E639-647. https://doi.org/10.1001/amajethics.2021.639.
Baruch Fischhoff. "The realities of risk-cost-benefit analysis." Science, 350 (2015): 527-534. https://doi.org/10.1126/science.aaa6516.
A. Culyer and K. Chalkidou. "Economic Evaluation for Health Investments En Route to Universal Health Coverage: Cost-Benefit Analysis or Cost-Effectiveness Analysis?." Value in Health, 22 (2019): 99- 103. https://doi.org/10.1016/j.jval.2018.06.005.
Xue Feng, David D. Kim, Joshua T. Cohen, P. Neumann and D. Ollendorf. "Using QALYs versus DALYs to measure cost-effectiveness: How much does it matter?." International Journal of Technology Assessment in Health Care, 36 (2020): 96- 103. https://doi.org/10.1017/S0266462320000124.
David D. Kim, M. C. Silver, N. Kunst, Joshua T. Cohen, D. Ollendorf and P. Neumann. "Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018." Pharmacoeconomics, 38 (2020): 1135- 1145. https://doi.org/10.1007/s40273-020-00942-2.
L. Savitz and Samuel T. Savitz. "Can delivery systems use cost-effectiveness analysis to reduce healthcare costs and improve value?." F1000Research, 5 (2016). https://doi.org/10.12688/f1000research.7531.1.
Oksuz, E., Malhan, S., Gonen, et al. (2021). Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey. Advances in Therapy, 38, 4935 - 4948. https://doi.org/10.1007/s12325-021-01874-9.
Ashley A. Leech, David D. Kim, Joshua T. Cohen and P. Neumann. "Use and Misuse of Cost-Effectiveness Analysis Thresholds in Low- and Middle-Income Countries: Trends in Cost-per-DALY Studies." Value in Health, 21 (2018): 759- 761. https://doi.org/10.1016/j.jval.2017.12.016.
Paul Van Gils Netherlands. "Workshop: Social Cost-Benefit Analyses in Public Health." European Journal of Public Health (2019). https://doi.org/10.1093/eurpub/ckz185.790.
Fan Yang, N. Devlin and N. Luo. "Cost-Utility Analysis Using EQ-5D-5L Data: Does How the Utilities Are Derived Matter?." Value in health: the journal of the International Society for Pharmacoeconomics and Outcomes Research, 22 1 (2019): 45-49. https://doi.org/10.1016/j.jval.2018.05.008.
V. Lau, F. Xie, J. Basmaji, et al. "Health-Related Quality-of-Life and Cost Utility Analyses in Critical Care: A Systematic Review*." Critical Care Medicine, 49 (2021): 575- 588. https://doi.org/10.1097/CCM.0000000000004851.
Robert M. Williams. "Distribution of emergency department costs.." Annals of emergency medicine, 28 6 (1996): 671-6 . https://doi.org/10.1016/S0196-0644(96)70092-6.
L. Baraff, James M Cameron, Rabinder Sekhon and Rabinder Sekhon. "Direct costs of emergency medical care: a diagnosis-based case-mix classification system.." Annals of emergency medicine, 20 1 (1991): 1-7 . https://doi.org/10.1016/S0196-0644(05)81108-4.
B. Bebo, Inna Cintina, N. Larocca, Leslie Ritter, Bari Talente, Daniel M. Hartung, S. Ngorsuraches, M. Wallin and Grace Yang. "The Economic Burden of Multiple Sclerosis in the United States." Neurology, 98 (2022): e1810- e1817. https://doi.org/10.1212/WNL.0000000000200150.
D. Floyd, S. Langham, Hélène Chevrou Séverac and B. Levesque. "The Economic and Quality-of-Life Burden of Crohn’s Disease in Europe and the United States, 2000 to 2013: A Systematic Review." Digestive Diseases and Sciences, 60 (2015): 299-312. https://doi.org/10.1007/s10620-014-3368-z.
E. Armbrecht, A. Shah, P. Schepman, R. Shah, E. Pappadopulos, R. Chambers, J. Stephens, S. Haider and R. McIntyre. "Economic and humanistic burden associated with noncommunicable diseases among adults with depression and anxiety in the United States." Journal of Medical Economics, 23 (2020): 1032- 1042. https://doi.org/10.1080/13696998.2020.1776297.
Mingshan Lu, Sumaiya Sharmin, Yong Tao, Xin Xia, Gongliang Yang, Yingying Cong, Guanhu Yang, Negar Razavilar, Riffat Aziz, Jing Jiang, Yun Xiao, Laura Peng and Bentong Xu. "Economic evaluation of acupuncture in treating patients with pain and mental health concerns: the results of the Alberta Complementary Health Integration Project." Frontiers in Public Health, 12 (2024). https://doi.org/10.3389/fpubh.2024.1362751.
Maneesh Sud, Bing Yu, H. Wijeysundera, P. Austin, D. Ko, Juarez R. Braga, P. Cram, J. Spertus, M. Domanski and Douglas S. Lee. "Associations Between Short or Long Length of Stay and 30-Day Readmission and Mortality in Hospitalized Patients With Heart Failure." JACC. Heart failure, 5 8 (2017): 578-588. https://doi.org/10.1016/j.jchf.2017.03.012.
E. Mujagic, W. Marti, M. Coslovsky, S. Soysal, R. Mechera, M. von Strauss, J. Zeindler, F. Saxer, A. Mueller, C. Fux, C. Kindler, L. Gurke and W. Weber. "Associations of Hospital Length of Stay with Surgical Site Infections." World Journal of Surgery, 42 (2018): 3888-3896. https://doi.org/10.1007/s00268-018-4733-4.
M. Franklin, R. Hunter, Ángel Enrique, Jorge E. Palacios and D. Richards. "Estimating Cost-Effectiveness Using Alternative Preference-Based Scores and Within-Trial Methods: Exploring the Dynamics of the Quality-Adjusted Life-Year Using the EQ-5D 5-Level Version and Recovering Quality of Life Utility Index." Value in health: the journal of the International Society for Pharmacoeconomics and Outcomes Research, 25 6 (2022): 1018-1029. https://doi.org/10.1016/j.jval.2021.11.1358.
Juan V. Luciano, C. G. Forero, Marta Cerdà-Lafont, M. Peñarrubia-María, R. Fernández-Vergel, A. Cuesta-Vargas, J. M. Ruíz, A. Rozadilla-Sacanell, Elena Sirvent-Alierta, Pilar Santo-Panero, J. García-Campayo, A. Serrano-Blanco, Adrián Pérez-Aranda and M. Rubio-Valera. "Functional Status, Quality of Life, and Costs Associated With Fibromyalgia Subgroups: A Latent Profile Analysis." The Clinical Journal of Pain, 32 (2016): 829–840. https://doi.org/10.1097/AJP.0000000000000336.
Devlin, N., & Brooks, R. (2017). EQ-5D and the EuroQol Group: Past, Present and Future. Applied Health Economics and Health Policy, 15, 127- 137. https://doi.org/10.1007/s40258-017-0310-5.
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., Bonsel, G., & Badia, X. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20, 1727- 1736. https://doi.org/10.1007/s11136-011-9903-x.
Rabin, R., & Charro, F. (2001). EQ-SD: a measure of health status from the EuroQol Group. Annals of Medicine, 33, 337- 343. https://doi.org/10.3109/07853890109002087.
Ware, J., & Sherbourne, C. (1992). The MOS 36-Item Short-Form Health Survey (SF-36). https://doi.org/10.1097/00005650-199206000-00002.
Ware, J. (2000). SF-36 Health Survey Update. Spine, 25, 3130-3139. https://doi.org/10.1097/00007632-200012150-00008.
Hays, R., Sherbourne, C., & Mazel, R. (1993). The RAND 36-Item Health Survey 1.0. Health economics, 2 3, 217-27. https://doi.org/10.1002/HEC.4730020305.
S. Gohil, R. Datta, Chenghua Cao, Michael J. Phelan, Vinh Q Nguyen, Armaan A. Rowther and Susan S. Huang. "Impact of Hospital Population Case-Mix, Including Poverty, on Hospital All-Cause and Infection-Related 30-Day Readmission Rates." Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 61 8 (2015): 1235-43. https://doi.org/10.1093/cid/civ539.
M. Rahmqvist, Annika Samuelsson, S. Bastami and H. Rutberg. "Direct health care costs and length of hospital stay related to health care-acquired infections in adult patients based on point prevalence measurements." American journal of infection control, 44 5 (2016): 500-6. https://doi.org/10.1016/j.ajic.2016.01.035.
Rachel Whitty, Sandra Porter, Kiran Battu, Pranjal Bhatt, E. Koo, Csilla Kalocsai, Peter E. Wu, Kendra Delicaet, I. Bogoch, R. Wu and J. Downar. "A pilot study of a Medication Rationalization (MERA) intervention." CMAJ open, 6 1 (2018): E87-E94. https://doi.org/10.9778/cmajo.20170134.
I. Petruschke, Florian Salm, M. Kaufmann, A. Freytag, J. Gensichen, M. Behnke, T. Kramer, R. Hanke, P. Gastmeier and S. Schneider. "Evaluation of a multimodal intervention to promote rational antibiotic use in primary care." Antimicrobial Resistance and Infection Control, 10 (2021). https://doi.org/10.1186/s13756-021-00908-9.
Emre Kara, Burcu Kelleci Çakır, M. Sancar and K. Demirkan. "Impact of Clinical Pharmacist-led Interventions in Turkey." Turkish journal of pharmaceutical sciences, 18 4 (2020): 517-526. https://doi.org/10.4274/tjps.galenos.2020.66735.
R. Sofat, S. Cremers, R. Ferner and R. Ferner. "Drug and therapeutics committees as guardians of safe and rational medicines use." British Journal of Clinical Pharmacology, 86 (2019): 10 - 12. https://doi.org/10.1111/bcp.14088.
A. Sommariva, L. Ansaloni, G. Baiocchi, S. Cascinu, R. Cirocchi, F. Coccolini, M. Deraco, G. Fiorentini, R. Gelmini, A. di Giorgio, P. Lippolis, E. Pasqual, C. Sassaroli, A. Macrì, P. Sammartino, S. Scaringi, M. Valle and M. Vaira. "Diagnostic and therapeutic algorithm for colorectal peritoneal metastases. A consensus of the peritoneal surface malignancies onco-team of the Italian society of surgical oncology." European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (2020). https://doi.org/10.1016/j.ejso.2020.09.035.
M. Vaira, M. Robella, M. Guaglio, P. Berchialla, A. Sommariva, M. Valle, E. Pasqual, F. Roviello, M. Framarini, G. Fiorentini, P. Sammartino, Alba Ilari Civit, A. di Giorgio, L. Ansaloni and M. Deraco. "Diagnostic and Therapeutic Algorithm for Appendiceal Tumors and Pseudomyxoma Peritonei: A Consensus of the Peritoneal Malignancies Oncoteam of the Italian Society of Surgical Oncology (SICO)." Cancers, 15 (2023). https://doi.org/10.3390/cancers15030728.
Anna-Kaija Palomaa, Saija Huhtala, A. Tuomikoski and T. Pölkki. "Effectiveness of technology-based interventions compared with other non-pharmacological interventions for relieving procedural pain in hospitalized neonates: a systematic review." JBI Evidence Synthesis, 21 (2023): 1549- 1581. https://doi.org/10.11124/JBIES-22-00179.
Erin Forbes, K. Clover, Amanda L. Baker, K. McCarter, S. Oultram, Mahesh Kumar, C. Wratten, M. T. Tieu, Jodie L Nixon and B. Britton. "Biofeedback Enabled CALM (BeCALM)—the feasibility of biofeedback on procedural anxiety during radiation therapy: study protocol for a pilot randomised controlled trial." BMJ Open, 12 (2022). https://doi.org/10.1136/bmjopen-2022-062467.
M. Taramasso, R. Hahn, H. Alessandrini, et al. "The International Multicenter TriValve Registry: Which Patients Are Undergoing Transcatheter Tricuspid Repair?." JACC. Cardiovascular interventions, 10 19 (2017): 1982-1990. https://doi.org/10.1016/j.jcin.2017.08.011.
P. Tajti, K. Alaswad, D. Karmpaliotis, F. Jaffer, R. Yeh, M. Patel, E. Mahmud, James W Choi, M. Burke, A. Doing, Philip Dattilo, C. Toma, A. J. Smith, B. Uretsky, E. Holper, S. Potluri, R. Wyman, D. Kandzari, S. Garcia, O. Krestyaninov, Dmitrii Khelimskii, M. Koutouzis, I. Tsiafoutis, J. Khatri, Wissam A Jaber, H. Samady, B. Jefferson, Taral N. Patel, Shuaib M. Abdullah, J. Moses, N. Lembo, M. Parikh, A. Kirtane, Z. Ali, Darshan Doshi, Iosif Xenogiannis, L. Stanberry, B. Rangan, I. Ungi, Subhash Banerjee and E. Brilakis. "Procedural Outcomes of Percutaneous Coronary Interventions for Chronic Total Occlusions Via the Radial Approach: Insights From an International Chronic Total Occlusion Registry." JACC. Cardiovascular interventions, 12 4 (2019): 346-358. https://doi.org/10.1016/j.jcin.2018.11.019.
K. Oakland, V. Jairath, R. Uberoi, R. Guy, Lakshmana Ayaru, N. Mortensen, M. Murphy and G. Collins. "Derivation and validation of a novel risk score for safe discharge after acute lower gastrointestinal bleeding: a modelling study." The lancet. Gastroenterology & hepatology, 2 9 (2017): 635-643. https://doi.org/10.1016/S2468-1253(17)30150-4.
C. Marincowitz, F. Lecky, V. Allgar, P. Hutchinson, H. Elbeltagi, Faye Johnson, E. Quinn, S. Tarantino, W. Townend, A. Kolias and T. Sheldon. "Development of a Clinical Decision Rule for the Early Safe Discharge of Patients with Mild Traumatic Brain Injury and Findings on Computed Tomography Brain Scan: A Retrospective Cohort Study." Journal of Neurotrauma, 37 (2019): 324- 333. https://doi.org/10.1089/neu.2019.6652.
T. Egelseer-Bruendl, B. Jahn, M. Arvandi, S. Puntscher, J. Santamaria, L. Brunelli, K. Weissenegger, B. Pfeifer, S. Neururer, C. Rissbacher, A. Huber, B. Fetz, C. Kleinheinz, R. Modre-Osprian, K. Kreiner, U. Siebert and G. Poelzl. "Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients—economic evaluation along a one-year observation period." Clinical Research in Cardiology, 113 (2024): 1232- 1241. https://doi.org/10.1007/s00392-024-02395-5.
Surya Singh, A. Gray, S. Shepperd, D. Stott, G. Ellis, A. Hemsley, P. Khanna, Scott Ramsay, R. Schiff, A. Tsiachristas, A. Wilkinson and John B. Young. "Is comprehensive geriatric assessment hospital at home a cost-effective alternative to hospital admission for older people?." Age and Ageing, 51 (2021). https://doi.org/10.1093/ageing/afab220.
Lesley Cryer, S. B. Shannon, Melanie Van Amsterdam and B. Leff. "Costs for 'hospital at home' patients were 19 percent lower, with equal or better outcomes compared to similar inpatients.." Health affairs, 31 6 (2012): 1237-43 . https://doi.org/10.1377/hlthaff.2011.1132.
Michael LoPresti and Ataru Igarashi. "A pragmatic review of cost-effective evaluations of reimbursed medical devices conducted for Japan." Journal of medical economics (2024): 1-27. https://doi.org/10.1080/13696998.2024.2420542.
T. Queiroz, M. Iori, Arthur Kramer and Y. Kuo. "Dynamic scheduling of patients in emergency departments." Eur. J. Oper. Res., 310 (2023): 100-116. https://doi.org/10.1016/j.ejor.2023.03.004.
Stefan Morreel, Ines Homburg, H. Philips, D. Graeve, K. Monsieurs, Jasmine Meysman, Eva Lefevere and V. Verhoeven. "Cost effects of nurse led triage at an emergency department with the advice to consult the adjacent general practice cooperative for low-risk patients, a cluster randomised trial." Health policy (2022). https://doi.org/10.1016/j.healthpol.2022.08.002.
Ricardo Collar Rebolho and Fabiano Maury Raupp. "Implementation costs of telephone nurse triage service.." Cadernos de saude publica, 39 3 (2023): e00095522 . https://doi.org/10.1590/0102-311XEN095522.
Verzelloni P, Adani G, Longo A, Di Tella S, Santunione AL, Vinceti M, Filippini T. Emergency department crowding: An assessment of the potential impact of the See-and-Treat protocol for patient flow management at an Italian hospital. Int Emerg Nurs. 2025 Feb;78:101569. doi: 10.1016/j.ienj.2024.101569. Epub 2025 Jan 9. PMID: 39793341.
Sarah Hsu, C. Thiel, M. Mello and J. Slutzman. "Dumpster Diving in the Emergency Department: Quantity and Characteristics of Waste at a Level I Trauma Center." Western Journal of Emergency Medicine, 21 (2020): 1211- 1217. https://doi.org/10.5811/westjem.2020.6.47900.
S. Azouz, Piper Boyll, Marco Swanson, Nikki Castel, T. Maffi and A. Rebecca. "Managing barriers to recycling in the operating room." American journal of surgery, 217 4 (2019): 634-638. https://doi.org/10.1016/j.amjsurg.2018.06.020.
Caroline Horrow and Aaron S Kesselheim. "Confronting High Costs And Clinical Uncertainty: Innovative Payment Models For Gene Therapies." Health affairs, 42 11 (2023): 1532-1540. https://doi.org/10.1377/hlthaff.2023.00527.
S. Ghabri, F. Hamers and J. Josselin. "Exploring Uncertainty in Economic Evaluations of Drugs and Medical Devices: Lessons from the First Review of Manufacturers’ Submissions to the French National Authority for Health." PharmacoEconomics, 34 (2016): 617-624. https://doi.org/10.1007/s40273-016-0381-4.
Edward Passos, P. Engels, J. Doyle, A. Beckett, B. Nascimento, S. Rizoli and H. Tien. "Societal costs of inappropriate emergency department thoracotomy." Journal of the American College of Surgeons, 214 1 (2012): 18-25. https://doi.org/10.1016/j.jamcollsurg.2011.09.020.
A. Haider, A. Obirieze, C. Velopulos, P. Richard, Asad Latif, Valerie K. Scott, C. Zogg, E. Haut, D. Efron, E. Cornwell, E. Mackenzie and D. Gaskin. "Incremental Cost of Emergency Versus Elective Surgery." Annals of Surgery (2015). https://doi.org/10.1097/SLA.0000000000001080.
Tara Li, Vladislav Berdunov, Robin Hamilton, Yaneth Gil Rojas, Christian Bührer, Oliver Cox, Roelien Postema and Marloes Bagijn. "Economic Assessment in Resource-Constrained Systems: Individual-Level Simulation Model in Wet Age-Related Macular Degeneration and Diabetic Macular Oedema." Ophthalmology and Therapy, 13 (2024): 2577- 2597. https://doi.org/10.1007/s40123-024-00999-8.
D. Wilkinson, S. Petrou and J. Savulescu. "Expensive care? Resource-based thresholds for potentially inappropriate treatment in intensive care." Monash Bioethics Review, 35 (2018): 2- 23. https://doi.org/10.1007/s40592-017-0075-5.
Jeffrey M. Muir, Amruta Radhakrishnan, I. Ozer Stillman and Grammati Sarri. "Health Equity Considerations in Cost-Effectiveness Analysis: Insights from an Umbrella Review." ClinicoEconomics and Outcomes Research: CEOR, 16 (2024): 581- 596. https://doi.org/10.2147/CEOR.S471827.
Sven Hartlieb, Thomas R. Loy and B. Eierle. "Does Community Social Capital Affect Asymmetric Cost Behaviour?." ORG: Ethics & Culture (Topic) (2019). https://doi.org/10.2139/ssrn.3013837.
R. Cookson, A. Mirelman, S. Griffin, M. Asaria, B. Dawkins, O. Norheim, S. Verguet and Anthony J. Culyer. "Using Cost-Effectiveness Analysis to Address Health Equity Concerns." Value in Health, 20 (2017): 206- 212. https://doi.org/10.1016/j.jval.2016.11.027.
M. Bertram, J. Lauer, Kees de Joncheere, T. Edejer, R. Hutubessy, M. Kieny and S. Hill. "Cost–effectiveness thresholds: pros and cons." Bulletin of the World Health Organization, 94 (2016): 925- 930. https://doi.org/10.2471/BLT.15.164418.
E. Keeney, H. Thom, E. Turner, Richard M. Martin, J. Morley and S. Sanghera. "Systematic Review of Cost-Effectiveness Models in Prostate Cancer: Exploring New Developments in Testing and Diagnosis." Value in Health, 25 (2020): 133- 146. https://doi.org/10.1016/j.jval.2021.07.002.
A. Pease, E. Zomer, D. Liew, C. Lo, A. Earnest and S. Zoungas. "Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis." Systematic Reviews, 9 (2020). https://doi.org/10.1186/s13643-020-01373.
Ashby, M. (2024). Using Home Telehealth to Reduce Hospital Readmission Rates in Heart Failure Patients in the Emergency Room. https://doi.org/10.46409/sr.ghjc4192.
B. Leurent, M. Gomes and J. Carpenter. "Missing data in trial‐based cost‐effectiveness analysis: An incomplete journey." Health Economics, 27 (2018): 1024- 1040. https://doi.org/10.1002/hec.3654.
M. Bertram, J. Lauer, K. Stenberg and T. Edejer. "Methods for the Economic Evaluation of Health Care Interventions for Priority Setting in the Health System: An Update From WHO CHOICE." International Journal of Health Policy and Management, 10 (2021): 673- 677. https://doi.org/10.34172/ijhpm.2020.244.
Malacinschi-Codreanu, T. (2022). Economic Evaluation of Laparoscopic/Classic Surgical Interventions in the Emergency Surgical Service. Intellectus. https://doi.org/10.56329/1810-7087.22.2.10.
H. Joo, Guijing Wang and Mary G. George. "Age-specific Cost Effectiveness of Using Intravenous Recombinant Tissue Plasminogen Activator for Treating Acute Ischemic Stroke." American journal of preventive medicine, 53 (2017): S205 - S212. https://doi.org/10.1016/j.amepre.2017.06.004.
Peter G. Delaney, O. Offorjebe and John Arudo. "Financing and cost-effectiveness of emergency medical services in low- and middle-income countries." Surgery (2024). https://doi.org/10.1016/j.surg.2024.06.032.
Rui Li, Ping Zhang, L. Barker, Farah M. Chowdhury and Xuanping Zhang. "Cost-Effectiveness of Interventions to Prevent and Control Diabetes Mellitus: A Systematic Review." Diabetes Care, 33 (2010): 1872 - 1894. https://doi.org/10.2337/dc10-0843.
D. Chisholm and S. Saxena. "Cost effectiveness of strategies to combat neuropsychiatric conditions in sub-Saharan Africa and South East Asia: mathematical modelling study." The BMJ, 344 (2012). https://doi.org/10.1136/bmj.e609.
Karen R. Siegel, Mohammed K. Ali, Xilin Zhou, B. Ng, Shawn Jawanda, Krista K. Proia, Xuanping Zhang, E. Gregg, A. Albright and Ping Zhang. "Cost-effectiveness of Interventions to Manage Diabetes: Has the Evidence Changed Since 2008?." Diabetes Care, 43 (2020): 1557 - 1592. https://doi.org/10.2337/figshare.12081801.
M. Linde, T. Steiner and D. Chisholm. "Cost-effectiveness analysis of interventions for migraine in four low- and middle-income countries." The Journal of Headache and Pain, 16 (2015). https://doi.org/10.1186/s10194-015-0496-6.
