Cargando…

Economic evaluation of clinical quality registries: a systematic review

OBJECTIVES: The objective of this systematic review was to examine the existing evidence base for the cost-effectiveness or cost-benefit of clinical quality registries (CQRs). DESIGN: Systematic review and narrative synthesis. DATA SOURCES: Nine electronic bibliographic databases, including MEDLINE,...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Peter, Chin, Ken, Liew, Danny, Stub, Dion, Brennan, Angela L, Lefkovits, Jeffrey, Zomer, Ella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924778/
https://www.ncbi.nlm.nih.gov/pubmed/31843824
http://dx.doi.org/10.1136/bmjopen-2019-030984
_version_ 1783481787029127168
author Lee, Peter
Chin, Ken
Liew, Danny
Stub, Dion
Brennan, Angela L
Lefkovits, Jeffrey
Zomer, Ella
author_facet Lee, Peter
Chin, Ken
Liew, Danny
Stub, Dion
Brennan, Angela L
Lefkovits, Jeffrey
Zomer, Ella
author_sort Lee, Peter
collection PubMed
description OBJECTIVES: The objective of this systematic review was to examine the existing evidence base for the cost-effectiveness or cost-benefit of clinical quality registries (CQRs). DESIGN: Systematic review and narrative synthesis. DATA SOURCES: Nine electronic bibliographic databases, including MEDLINE, EMBASE and CENTRAL, in the period from January 2000 to August 2019. ELIGIBILITY CRITERIA: Any peer-reviewed published study or grey literature in English which had reported on an economic evaluation of one or more CQRs. DATA EXTRACTION AND SYNTHESIS: Data were screened, extracted and appraised by two independent reviewers. A narrative synthesis was performed around key attributes of each CQR and on key patient outcomes or changes to healthcare processes or utilisation. A narrative synthesis of the cost-effectiveness associated with CQRs was also conducted. The primary outcome was cost-effectiveness, in terms of the estimated incremental cost-effectiveness ratio (ICER), cost savings or return-on-investment (ROI) attributed to CQR implementation. RESULTS: Three studies and one government report met the inclusion criteria for the review. A study of the National Surgical Quality Improvement Programme (NSQIP) in the USA found that the cost-effectiveness of this registry improved over time, based on an ICER of US$8312 per postoperative event avoided. A separate study in Canada estimated the ROI to be US$3.43 per US$1.00 invested in the NSQIP. An evaluation of a post-splenectomy CQR in Australia estimated that registry cost-effectiveness improved from US$234 329 to US$18 358 per life year gained when considering the benefits accrued over the lifetime of the population. The government report evaluating five Australian CQRs estimated an overall return of 1.6–5.5 times the cost of investment. CONCLUSIONS: Available data indicate that CQRs can be cost-effective and can lead to significant returns on investment. It is clear that further studies that evaluate the economic and clinical impacts of CQRs are necessary. PROSPERO REGISTRATION NUMBER: CRD42018116807.
format Online
Article
Text
id pubmed-6924778
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-69247782020-01-02 Economic evaluation of clinical quality registries: a systematic review Lee, Peter Chin, Ken Liew, Danny Stub, Dion Brennan, Angela L Lefkovits, Jeffrey Zomer, Ella BMJ Open Health Economics OBJECTIVES: The objective of this systematic review was to examine the existing evidence base for the cost-effectiveness or cost-benefit of clinical quality registries (CQRs). DESIGN: Systematic review and narrative synthesis. DATA SOURCES: Nine electronic bibliographic databases, including MEDLINE, EMBASE and CENTRAL, in the period from January 2000 to August 2019. ELIGIBILITY CRITERIA: Any peer-reviewed published study or grey literature in English which had reported on an economic evaluation of one or more CQRs. DATA EXTRACTION AND SYNTHESIS: Data were screened, extracted and appraised by two independent reviewers. A narrative synthesis was performed around key attributes of each CQR and on key patient outcomes or changes to healthcare processes or utilisation. A narrative synthesis of the cost-effectiveness associated with CQRs was also conducted. The primary outcome was cost-effectiveness, in terms of the estimated incremental cost-effectiveness ratio (ICER), cost savings or return-on-investment (ROI) attributed to CQR implementation. RESULTS: Three studies and one government report met the inclusion criteria for the review. A study of the National Surgical Quality Improvement Programme (NSQIP) in the USA found that the cost-effectiveness of this registry improved over time, based on an ICER of US$8312 per postoperative event avoided. A separate study in Canada estimated the ROI to be US$3.43 per US$1.00 invested in the NSQIP. An evaluation of a post-splenectomy CQR in Australia estimated that registry cost-effectiveness improved from US$234 329 to US$18 358 per life year gained when considering the benefits accrued over the lifetime of the population. The government report evaluating five Australian CQRs estimated an overall return of 1.6–5.5 times the cost of investment. CONCLUSIONS: Available data indicate that CQRs can be cost-effective and can lead to significant returns on investment. It is clear that further studies that evaluate the economic and clinical impacts of CQRs are necessary. PROSPERO REGISTRATION NUMBER: CRD42018116807. BMJ Publishing Group 2019-12-15 /pmc/articles/PMC6924778/ /pubmed/31843824 http://dx.doi.org/10.1136/bmjopen-2019-030984 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Health Economics
Lee, Peter
Chin, Ken
Liew, Danny
Stub, Dion
Brennan, Angela L
Lefkovits, Jeffrey
Zomer, Ella
Economic evaluation of clinical quality registries: a systematic review
title Economic evaluation of clinical quality registries: a systematic review
title_full Economic evaluation of clinical quality registries: a systematic review
title_fullStr Economic evaluation of clinical quality registries: a systematic review
title_full_unstemmed Economic evaluation of clinical quality registries: a systematic review
title_short Economic evaluation of clinical quality registries: a systematic review
title_sort economic evaluation of clinical quality registries: a systematic review
topic Health Economics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924778/
https://www.ncbi.nlm.nih.gov/pubmed/31843824
http://dx.doi.org/10.1136/bmjopen-2019-030984
work_keys_str_mv AT leepeter economicevaluationofclinicalqualityregistriesasystematicreview
AT chinken economicevaluationofclinicalqualityregistriesasystematicreview
AT liewdanny economicevaluationofclinicalqualityregistriesasystematicreview
AT stubdion economicevaluationofclinicalqualityregistriesasystematicreview
AT brennanangelal economicevaluationofclinicalqualityregistriesasystematicreview
AT lefkovitsjeffrey economicevaluationofclinicalqualityregistriesasystematicreview
AT zomerella economicevaluationofclinicalqualityregistriesasystematicreview