Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan

Kinoshita, Takahiro; Moriwaki, Kensuke; Hanaki, Nao; Kitamura, Tetsuhisa; Yamakawa, Kazuma; Fukuda, Takashi; Hunink, Myriam G.M.; Fujimi, Satoshi

doi:https://doi.org/10.1186/s13017-020-00344-x

Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan

Kinoshita, Takahiro; Moriwaki, Kensuke; Hanaki, Nao et al.

World Journal of Emergency Surgery, 2021, 16, 2

Number of Access:534（2025-10-21 11:11 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78363

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Title	Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan
Creator	CreatorName Kinoshita, Takahiro
	NRID 1000010514862 1000010514862 CreatorName Moriwaki, Kensuke
	NRID 1000040817631 1000040817631 researchmap permalink kullervo1892 kullervo1892 CreatorName Hanaki, Nao
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 CreatorName Kitamura, Tetsuhisa
	NRID 1000050597507 1000050597507 CreatorName Yamakawa, Kazuma
	NRID 1000040272421 1000040272421 CreatorName Fukuda, Takashi
	CreatorName Hunink, Myriam G.M.
	CreatorName Fujimi, Satoshi
Subject	HERS
	ICER
	Markov model
	QALY
	Utility
Description	Kinoshita, T., Moriwaki, K., Hanaki, N. et al. Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan. World J Emerg Surg 16, 2 (2021). https://doi.org/10.1186/s13017-020-00344-x
Abstract	Background: Hybrid emergency room (ER) systems, consisting of an angiography-computed tomography (CT) machine in a trauma resuscitation room, are reported to be effective for reducing death from exsanguination in trauma patients. We aimed to investigate the cost-effectiveness of a hybrid ER system in severe trauma patients without severe traumatic brain injury (TBI). Methods: We conducted a cost-utility analysis comparing the hybrid ER system to the conventional ER system from the perspective of the third-party healthcare payer in Japan. A short-term decision tree and a long-term Markov model using a lifetime time horizon were constructed to estimate quality-adjusted life years (QALYs) and associated lifetime healthcare costs. Short-term mortality and healthcare costs were derived from medical records and claims data in a tertiary care hospital with a hybrid ER. Long-term mortality and utilities were extrapolated from the literature. The willingness-to-pay threshold was set at $47,619 per QALY gained and the discount rate was 2%. Deterministic and probabilistic sensitivity analyses were conducted. Results: The hybrid ER system was associated with a gain of 1.03 QALYs and an increment of $33,591 lifetime costs compared to the conventional ER system, resulting in an ICER of $32,522 per QALY gained. The ICER was lower than the willingness-to-pay threshold if the odds ratio of 28-day mortality was < 0.66. Probabilistic sensitivity analysis indicated that the hybrid ER system was cost-effective with a 79.3% probability. Conclusion: The present study suggested that the hybrid ER system is a likely cost-effective strategy for treating severe trauma patients without severe TBI.
Publisher	BioMed Central Ltd
Source Title	World Journal of Emergency Surgery
Volume (Issue)	16
Page	2
Date of Issued	2021-01-07
Language	English
Handle URL	https://hdl.handle.net/11094/78363
eISSN	17497922
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1186/s13017-020-00344-x
Access Rights	open access
CopyRight	© 2021 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	World Journal of Emergency Surgery. 2021, 16, p. 2
DC.title	Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan
DC.creator	Kinoshita, Takahiro
	Moriwaki, Kensuke
	Hanaki, Nao
	Kitamura, Tetsuhisa
	Yamakawa, Kazuma
	Fukuda, Takashi
	Hunink, Myriam G.M.
	Fujimi, Satoshi
DC.publisher	BioMed Central Ltd
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2021-01-07
DC.identifier	https://doi.org/10.1186/s13017-020-00344-x
DC.subject	HERS
	ICER
	Markov model
	QALY
	Utility
DC.description	Kinoshita, T., Moriwaki, K., Hanaki, N. et al. Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan. World J Emerg Surg 16, 2 (2021). https://doi.org/10.1186/s13017-020-00344-x
DCTERMS.abstract	Background: Hybrid emergency room (ER) systems, consisting of an angiography-computed tomography (CT) machine in a trauma resuscitation room, are reported to be effective for reducing death from exsanguination in trauma patients. We aimed to investigate the cost-effectiveness of a hybrid ER system in severe trauma patients without severe traumatic brain injury (TBI). Methods: We conducted a cost-utility analysis comparing the hybrid ER system to the conventional ER system from the perspective of the third-party healthcare payer in Japan. A short-term decision tree and a long-term Markov model using a lifetime time horizon were constructed to estimate quality-adjusted life years (QALYs) and associated lifetime healthcare costs. Short-term mortality and healthcare costs were derived from medical records and claims data in a tertiary care hospital with a hybrid ER. Long-term mortality and utilities were extrapolated from the literature. The willingness-to-pay threshold was set at $47,619 per QALY gained and the discount rate was 2%. Deterministic and probabilistic sensitivity analyses were conducted. Results: The hybrid ER system was associated with a gain of 1.03 QALYs and an increment of $33,591 lifetime costs compared to the conventional ER system, resulting in an ICER of $32,522 per QALY gained. The ICER was lower than the willingness-to-pay threshold if the odds ratio of 28-day mortality was < 0.66. Probabilistic sensitivity analysis indicated that the hybrid ER system was cost-effective with a 79.3% probability. Conclusion: The present study suggested that the hybrid ER system is a likely cost-effective strategy for treating severe trauma patients without severe TBI.
DC.rights	© 2021 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	78363
citation_title	Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan
citation_author	Kinoshita, Takahiro
	Moriwaki, Kensuke
	Hanaki, Nao
	Kitamura, Tetsuhisa
	Yamakawa, Kazuma
	Fukuda, Takashi
	Hunink, Myriam G.M.
	Fujimi, Satoshi
citation_publisher	BioMed Central Ltd
citation_language	English
citation_date	2021-01-07
citation_journal_title	World Journal of Emergency Surgery
citation_volume	16
citation_firstpage	2
citation_doi	https://doi.org/10.1186/s13017-020-00344-x
citation_public_url	https://hdl.handle.net/11094/78363

Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan

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