TY - JOUR
AU - Egdell, Robin M.
AB - Background The UK government has attempted to improve the quality of health care in the National Health Service and minimize geographical variations in quality by imposing targets in certain areas of health care. The measures taken by local health economies to achieve these targets have not before been subjected to cost-effectiveness analysis. We have assessed the cost effectiveness of an intervention designed to achieve thrombolysis time targets.Methods In the setting of a single district general hospital in England, we audited local pain-to-needle (PTN) and door-to-needle (DTN) times, before and after a £208 000 (€310 000, $370 000) annual expenditure to improve performance against government targets. The intervention included the recruitment of additional nursing time in the Accident & Emergency Department and the use of a single bolus thrombolytic agent for all patients with ST elevation myocardial infarction. An economic evaluation was performed, based on the expected number of additional lives saved, extrapolated from a meta-analysis of previous thrombolysis trials.Results The intervention reduced mean DTN time from 37.6 ± 5.9 minutes (mean ± SEM) to 27.6 ± 3.6 minutes (p = 0.06). The cost per life saved was £3 423 ± 850 (€5 100 000, $6 100 000), the cost per life year gained was £222 184 (€330 000, $390 000) and the cost per quality-adjusted life year (QALY) gained was £246 871 (€370 000, $440 000).Conclusion Although moderately successful at improving performance against government targets, this intervention to promote rapid thrombolysis proved to be an inefficient use of health-care resources. Strict government targets in health care may not always lead to efficient targeting of resources.
TI - Is a target culture in health care always compatible with efficient use of resources? A cost-effectiveness analysis of an intervention to achieve thrombolysis targets
JF - Journal of Public Health
DO - 10.1093/pubmed/fdi072
DA - 2006-03-25
UR - https://www.deepdyve.com/lp/oxford-university-press/is-a-target-culture-in-health-care-always-compatible-with-efficient-tetlxSTxwX
SP - 31
EP - 34
VL - 28
IS - 1
DP - DeepDyve
ER -