Archives of otolaryngology--head & neck surgery · 1999
A prospective study of the cost-utility of the multichannel cochlear implant.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Palmer C S, Niparko J K, Wyatt J R, Rothman M, de Lissovoy G
Аннотация
CONTEXT: Prior clinical studies have indicated that cochlear implantation provides benefits to individuals with advanced sensorineural hearing loss who are unable to gain effective speech recognition with hearing aids.
OBJECTIVE: To determine the cost per quality-adjusted life-year (QALY) for adults receiving multichannel cochlear implants.
DESIGN: Prospective 12-month multicenter study using preference-based quality-of-life measures and total cost determinations, comparing profoundly hearing-impaired adult subjects with and without cochlear implants.
SETTING: Hospital-based and patient-resource clinics.
PATIENTS: Severely to profoundly hearing-impaired adult recipients of a cochlear implant and adults eligible for the device who had not yet received it.
MAIN OUTCOME MEASURE: Clinical assessment of implant participants included medical and audiologic (speech understanding) data at the time of enrollment, 6 months, and 12 months. All participants' health-utility was assessed at the time of enrollment, 6 months, and 12 months using the Health Utility Index. One-year medical resource utilization and cost data included bills related to implants, patient diaries, charge estimates from clinical sites, and published literature. A decision model was developed to determine cost per QALY.
RESULTS: Of the 84 enrolled adults, 62 (75%) completed the study. Mean health-utility scores at the time of enrollment were identical between groups. The marginal 12-month health-utility gain for implant recipients was 0.20; 90% of this improvement was achieved within 6 months. For patients with a mean 22-year life expectancy, the marginal cost per QALY was $14,670.
CONCLUSIONS: Overall, multichannel cochlear implants significantly improved recipients' performance on measures of speech understanding and ratings of health-utility within 6 months of implantation. The multichannel cochlear implant yielded a very favorable cost per QALY.
OBJECTIVE: To determine the cost per quality-adjusted life-year (QALY) for adults receiving multichannel cochlear implants.
DESIGN: Prospective 12-month multicenter study using preference-based quality-of-life measures and total cost determinations, comparing profoundly hearing-impaired adult subjects with and without cochlear implants.
SETTING: Hospital-based and patient-resource clinics.
PATIENTS: Severely to profoundly hearing-impaired adult recipients of a cochlear implant and adults eligible for the device who had not yet received it.
MAIN OUTCOME MEASURE: Clinical assessment of implant participants included medical and audiologic (speech understanding) data at the time of enrollment, 6 months, and 12 months. All participants' health-utility was assessed at the time of enrollment, 6 months, and 12 months using the Health Utility Index. One-year medical resource utilization and cost data included bills related to implants, patient diaries, charge estimates from clinical sites, and published literature. A decision model was developed to determine cost per QALY.
RESULTS: Of the 84 enrolled adults, 62 (75%) completed the study. Mean health-utility scores at the time of enrollment were identical between groups. The marginal 12-month health-utility gain for implant recipients was 0.20; 90% of this improvement was achieved within 6 months. For patients with a mean 22-year life expectancy, the marginal cost per QALY was $14,670.
CONCLUSIONS: Overall, multichannel cochlear implants significantly improved recipients' performance on measures of speech understanding and ratings of health-utility within 6 months of implantation. The multichannel cochlear implant yielded a very favorable cost per QALY.
Предметные рубрики MeSH
AdultAgedCochlear ImplantationCochlear ImplantsCost-Benefit AnalysisCosts and Cost AnalysisDeafnessDecision Support TechniquesFemaleFollow-Up StudiesHealth Care CostsHealth ResourcesHealth StatusHumansLife ExpectancyMaleMedical RecordsMiddle AgedProspective StudiesProsthesis DesignQuality of LifeQuality-Adjusted Life YearsSpeech Perception