量化生物风险因素对医疗保健成本的因果关系影响
Jiwoo Lee1,2,3,4, Sakari Jukarainen2, Antti Karvanen2
1Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Nature communications
|September 13, 2023
概括
临床风险因素显著影响医疗保健成本. 门德尔随机化揭示了腰围,BMI和血压增加成本,而一些生物标志物没有显示出因果关系.
科学领域:
- 遗传学和健康经济学 遗传学和健康经济学
- 流行病学 流行病学
- 生物标志物和成本分析
背景情况:
- 评估医疗保健干预措施需要了解临床风险因素和医疗保健支出之间的因果关系.
- 确定可修改的风险因素对于具有成本效益的医疗保健策略至关重要.
研究的目的:
- 使用基因信息方法确定15种临床风险因素对年度医疗保健总成本的因果关系.
- 量化特定风险因素与大量人口群体的医疗保健支出之间的关联.
主要方法:
- 采用孟德尔随机化 (MR),一个强大的遗传流行病学设计,推断因果关系.
- 分析了FinnGen研究中的373,160名参与者的医疗保健费用,并验证了来自英国和荷兰队列的323,774名个人的研究结果.
主要成果:
- 发现腰围 (WC),成人体重指数 (BMI) 和静脉血压对医疗保健费用的显著因果关系.
- 标准偏差增加的WC,BMI和缩血压对应于每年医疗费用分别增加了22.78%,13.64%和13.08%.
- 对于白蛋白,C反应蛋白和维生素D等生物标志物,没有观察到显著的因果关系.
结论:
- 增加的腰围是年度医疗保健成本的重要驱动因素,突出其临床意义.
- 调查结果表明,优先考虑WC查,监测和缓解策略,以管理医疗保健支出.
- 该研究强调了MR在剖析风险因素和健康经济学之间的因果关系方面的有用性.
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