Decision analysis about the cost-effectiveness of different in vitro fertilization-embryo transfer protocol under considering governments, hospitals, and patient
单位:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Canc Biol Res Ctr,Wuhan,Hubei,Peoples R China肿瘤生物医学中心华中科技大学同济医学院附属同济医院妇产科学系妇科肿瘤[2]Wuhan Univ, Sch Econ & Management, Wuhan, Hubei, Peoples R China[3]Wuhan Univ, Management Sci & Data Analyt Res Ctr, Wuhan, Hubei, Peoples R China
Objective: The aim of this study was to explore the benefits of in vitro fertilization (IVF) for patients and hospitals under different protocols and if IVF treatment should be incorporated into health care. Perspective: The government should consider including IVF treatment in health insurance. Hospitals and patients could obtain the best benefit by following the hospital's recommended protocol. Setting: This retrospective study was conducted from January 2014 to August 2017 at an academic hospital. Methods: A total of 7440 patients used gonadotropin-releasing hormone agonists (GnRHa) protocol, 2619 patients used, gonadotropin-releasing hormone antagonists (GnRHant) protocol, and 1514 patients used GnRHa ultra-long protocol. Primary outcomes were live birth rate (LBR), cost-effectiveness, hospital revenue, and government investment. Results: The cycle times for the GnRHa protocol and the GnRHa ultra-long protocol were significantly higher than the GnRHant protocol. Patients who were <= 29 years chose the GnRHant protocol. The cost of a successful cycle was 67,579.39 +/- 9,917.55 (sic) and LBR was 29.25%. Patients who were > 30 years had the GnRHa protocol as the dominant strategy, as it was more effective at lower costs and higher LBR. When patients were > 30 to <= 34 years, the cost of a successful cycle was 66,556.7 +/- 8,448.08 (sic) and the LBR was 31.05%. When patients were > 35 years, the cost of a successful cycle was 83,297.92 +/- 10,918.05 (sic) and the LBR was 25.07%. The government reimbursement for a cycle ranged between 11,372.12 +/- 2,147.71 (sic) and 12,753.67 +/- 1,905.02 (sic). Conclusions: The government should consider including IVF treatment in health insurance. Hospitals recommend the GnRHant protocol for patients < 29 years old and the GnRHa protocol for patients > 30 years old, to obtain the best benefits. Patients could obtain the best benefit by using the protocol recommended by the hospital.
基金:
National Nature Science Foundation of China (NSFC)National Natural Science Foundation of China (NSFC) [81672085, 71373188, 81372804, U1333115, 30901586]; Chinese medical association of clinical medicine special funds for scientific research projects [17020400709]
第一作者单位:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Canc Biol Res Ctr,Wuhan,Hubei,Peoples R China[2]Wuhan Univ, Sch Econ & Management, Wuhan, Hubei, Peoples R China[3]Wuhan Univ, Management Sci & Data Analyt Res Ctr, Wuhan, Hubei, Peoples R China
通讯作者:
通讯机构:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Canc Biol Res Ctr,Wuhan,Hubei,Peoples R China[*1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Wuhan 430030,Hubei,Peoples R China
推荐引用方式(GB/T 7714):
Pan Wei,Tu Haiting,Jin Lei,et al.Decision analysis about the cost-effectiveness of different in vitro fertilization-embryo transfer protocol under considering governments, hospitals, and patient[J].MEDICINE.2019,98(19):doi:10.1097/MD.0000000000015492.
APA:
Pan, Wei,Tu, Haiting,Jin, Lei,Hu, Cheng,Li, Yuehan...&Liao, ShuJie.(2019).Decision analysis about the cost-effectiveness of different in vitro fertilization-embryo transfer protocol under considering governments, hospitals, and patient.MEDICINE,98,(19)
MLA:
Pan, Wei,et al."Decision analysis about the cost-effectiveness of different in vitro fertilization-embryo transfer protocol under considering governments, hospitals, and patient".MEDICINE 98..19(2019)