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Decision analysis about the cost-effectiveness of different in vitro fertilization-embryo transfer protocol under considering governments, hospitals, and patient

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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
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关键词: cost-effectiveness decision tree models health insurance hospital service efficiency return on investment

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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.

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出版当年[2018]版:
大类 | 4 区 医学
小类 | 3 区 医学:内科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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出版当年[2017]版:
Q2 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q2 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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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
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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
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