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研究生(外文):Hung, Shih-Ting
論文名稱:人工耳蝸遠程調頻成本效益分析與發展 – 以美國為例
論文名稱(外文):Cost-Benefit Analysis and Development of Remote Programming for Cochlear Implants in the United States
指導教授(外文):Tsai, Hwei-An
外文關鍵詞:Cochlear ImplantRemote ProgrammingCost-EffectivenessOn- site programmingHearing Lossthe United States
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Cochlear implantation explores remote programming for efficient and cost-effective solutions. In the US, around 48 million people have hearing impairment, with cochlear implants used for severe cases. Yet, implant adoption remains low, and outdated studies ignore remote programming. This study aims to bridge this gap, showcasing remote programming's potential and comparing its cost-effectiveness with on-site methods.

Using a Markov model and TreeAge software, our study assesses post-implantation events and complications, measuring cost-effectiveness in monetary terms, QALY (Quality-Adjusted Life Years), and ICER (Incremental Cost Effectiveness Ratio). In our analysis, the traditional model's ICER is $88128, implying an extra cost of $88128 for each added quality unit. We evaluate costs against a threshold of $26,700 to $41,400 to gauge acceptability and found out that the traditional model surpasses this range, lowering patient acceptability.

Overall, our findings suggest that the traditional on-site programming might not be cost-effective compared to the remote programming model, as it incurs higher costs without significant added benefits. This holds significance for patients who frequently visit the implant center due to travel demands, making the routine burdensome. In contrast, remote programming offers flexibility for maintenance, enhancing patient satisfaction in the long term.
Chinese Abstract i
English Abstract ii
Table of Contents iii
List of Figures v
List of Tables vi
1. Introduction 1
2. Industrial Stylized Facts 2
2.1 Hearing Loss in the United States 2
2.2 Cochlear Implant in the United States 3
2.3 Key Player Analysis 4
3. Literature Review 7
3.1 Cochlear Implant and Its Main Process 7
3.2 Cochlear Implant Mapping and Programming 10
3.3 The New Model of Remote Programming and Its Contribution to Cochlear Implantation 10
3.4 Markov Model 12
3.5 The Utilization of Markov Models in Healthcare and Economic Evaluation for New Treatment 13
3.6 TreeAge 13
4. Theoretical and Empirical Model 15
4.1 Model Structure 15
4.2 Hypothesis 16
4.2.1 Device Failure in Cochlear Implants: Implications for Revision Surgery and Patient Outcomes. 16
4.2.2 Major Complications in Cochlear Implants: Impacts, Management, and Surgical Considerations. 17
4.2.3 Balancing Risks and Benefits: Understanding Potential Complications of Cochlear Implant Surgery 18
5. Empirical Studies 19
5.1 Variable Specification 19
5.2 Input Parameters and Data Source 21
5.3 Empirical Results 25
6. Conclusion 35
7. References 37
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