与肺动脉高血压相关的社会成本 肺动脉高血压小组:使用链接国家注册表的研究
Barbro Kjellström1, Bodil Ivarsson2, Magnus Husberg3
1Department of Clinical Sciences Lund Clinical Physiology and Skåne University Hospital, Lund University Lund Sweden.
肺动脉高血压 (PAH) 显著增加了社会成本,特别是在诊断后. 自发性/遗传性PAH (IPAH/HPAH) 在诊断后承担最高的费用,主要是医疗费用.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 肺动脉高血压 (PAH) 是一种复杂的疾病,有各种亚型,包括异常/遗传性PAH (IPAH/HPAH),以及与结缔组织疾病 (APAH-CTD) 和先天性心脏病 (APAH-CHD) 相关的亚型.
- 与PAH相关的社会成本,无论是在诊断前还是诊断后,在不同亚组中都没有很好地描述.
研究的目的:
- 估计和比较国家PAH队列中的社会成本,分层分组,在诊断前5年和诊断后5年.
- 将这些成本与匹配的对照组进行比较,以了解PAH的经济负担.
主要方法:
- 利用瑞典国家数据库链接患者数据并估计社会成本.
- 包括在2008-2019年期间诊断出PAH的事件患者,并根据年龄,性别和地理位置与对照组1:5匹配.
- 分析了诊断前后的成本,确定了患者和对照组的主要成本驱动因素.
主要成果:
- 在诊断前,所有PAH亚组的社会成本与对照组相比 (2.9-4.3倍) 高得多.
- 在诊断后,PAH组的成本进一步显著增加 (1.6-3.1倍),而对照组的成本则下降.
- 诊断后,医疗保健费用 (包括药物和住院/门诊护理) 成为PAH患者的主要驱动因素,占直接成本的很大一部分,而住院费用占据了对照组的成本.
结论:
- 这种PAH给社会带来了巨大的经济负担,诊断后成本大幅上升.
- 在诊断前,APAH-CHD的相对社会成本最高,而在诊断后的IPAH/HPAH的总体社会成本最高.
- 调查结果强调了PAH的重大经济影响,强调需要具有成本效益的管理策略和支持系统.
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