与口服皮质类固醇相关的医疗保健资源利用率和COPD患者的相关成本
Gary Tse1,2, Cono Ariti1, Mona Bafadhel3
1Observational and Pragmatic Research Institute, Singapore, Singapore.
Advances in therapy
|November 19, 2024
概括
口服皮质类固醇 (OCS) 增加了慢性阻塞性肺病 (COPD) 患者的医疗保健利用率和成本. 较高的累积OCS剂量与更高的疾病特异性出勤率和费用相关,突出显示了剂量-反应关系.
科学领域:
- 肺部医学 肺部医学
- 药物经济学 药物经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 口服皮质类固醇 (OCS) 可以治疗慢性阻塞性肺病 (COPD) 恶化,但会产生不良后果.
- 这些不利结果可能会加剧医疗保健资源利用率和相关成本.
- 了解OCS对医疗保健利用的影响对于COPD管理策略至关重要.
研究的目的:
- 为了比较与OCS相关的不良结果相关的医疗保健出席率和成本.
- 评估之前使用OCS和没有使用OCS的患者之间的差异.
- 检查OCS累积暴露和医疗保健利用/成本之间的剂量反应关系.
主要方法:
- 一项直接匹配的观察队列研究利用了英国临床实践研究Datalink GOLD数据库 (1987-2019).
- 包括2003年4月1日之后被诊断出COPD的患者,并与医院病例统计数据联系.
- 分析了急诊室,门诊 (专家/初级护理) 和住院病人的出勤和相关费用,经过调整以考虑混因素.
主要成果:
- 与非OCS队列相比,OCS队列的年度特定疾病出勤率和成本显著更高.
- 在大多数类别中,参加和成本显示出与OCS累积暴露的剂量-反应关系是正的.
- 初级保健咨询,非选择性短期停留和长期停留表明,随着较高的OCS剂量 (≥10g),成本大幅增加.
结论:
- 在COPD患者中,与OCS相关的不良结果与医疗保健出勤率和成本的增加有关.
- 在OCS累积暴露和医疗保健利用/成本之间存在明显的积极剂量反应关系.
- 这些发现强调了OCS不良事件在COPD管理中的经济负担.
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