美国和丹麦的老年人心血管住院病例
Frederikke Held Berg1,2,3, Mats C Højbjerg Lassen2,3,4, Muthiah Vaduganathan4
1Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
JAMA cardiology
|February 5, 2025
概括
美国的心血管住院率高于丹麦,特别是心脏病发作和心力衰竭. 美国与丹麦相比,心血管事件的收入差异明显更大.
科学领域:
- 公共卫生 公共卫生
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心血管疾病 (CVD) 是美国的主要死亡原因.
- 国际上对心血管疾病负担的比较是有限的,特别是在不同的医疗保健系统之间.
- 了解心血管疾病的收入相关差异对于有针对性的干预至关重要.
研究的目的:
- 为了比较心血管住院率 (急性心肌梗塞[MI],心力衰竭[HF],缺血性中风) 和65岁或以上成年人之间的相关结果,美国和丹麦之间.
- 分析这些利率的整体和收入水平.
- 评估心血管事件住院后的30天全因死亡率.
主要方法:
- 基于人口的横截面研究,利用美国 (医疗保险受益者) 和丹麦的国家数据.
- 研究期间:2021年1月1日至2022年1月1日.
- 主要结局:因心脏病发作,高血压,缺血性中风和30天全因死亡率的年龄和性别标准化住院率.
主要成果:
- 与丹麦相比,美国的年龄和性别标准化心血管住院率 (RR,1.50) 和30天死亡率 (RR,1.12) 显著更高.
- 在美国,因心脏病发作 (RR,1.56) 和高血压 (RR,2.37) 观察到更高的住院风险,而因缺血性中风住院的风险较低 (RR,0.90).
- 美国低收入成年人与高收入成年人 (RR, 2.38) 的整体心血管住院率高出两倍以上,但在丹麦 (RR, 1.45) 的差异较小.
结论:
- 与丹麦相比,美国的心血管住院率要高得多.
- 在这两个国家,心血管住院患者的收入差异显著,但在美国明显更大.
- 这些发现凸显了针对性战略的必要性,以解决心血管疾病负担和医疗保健中的收入相关不平等问题.
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