慢性淋巴细胞白血病患者的护理连续性:对现实数据的分析
Sameh Gabella1, Manoj Khanal2, Yongmei Chen2
1Moffitt Cancer Center, Tampa, FL USA.
Journal of medical economics
|August 29, 2025
概括
慢性淋巴细胞白血病 (CLL) 患者接受共价布鲁顿氨酸激酶抑制剂 (cBTKi) 治疗的治疗连续性 (CoC) 显著减少了急诊室的访问和住院. 持续的瘤医生/血液学家护理与较少的医疗事件有关.
科学领域:
- 癌症学
- 医疗服务研究
- 血液学
背景情况:
- 接受共价布鲁顿氨酸激酶抑制剂 (cBTKi) 治疗的慢性淋巴细胞白血病 (CLL) 患者需要大量的医疗资源.
- 医疗连续性 (CoC) 假设会影响CLL患者的医疗结果.
- 了解COC与医疗保健利用之间的关系对于优化患者管理至关重要.
研究的目的:
- 在接受cBTKi治疗的CLL患者中,研究更多的护理连续性 (CoC) 与减少医疗资源利用 (急诊,住院) 以及改善整体存活率 (OS) 之间的关联.
- 通过赫芬达尔-希尔施曼指数 (HHI) 量化对医疗保健结果的影响.
主要方法:
- 从Optum的Clinformatics® Data Mart数据库中对非身份化数据进行了回顾性分析.
- 包括诊断为CLL的5990名接受cBTKi治疗的患者.
- 使用Herfindahl-Hirschman指数 (HHI) 测量CoC,结果包括急诊,住院和OS.
- 使用多变量回归模型 (逻辑,负二项式,Cox比例危险) 调整为基线共变量.
主要成果:
- 较高的CoC (中位数HHI=0. 7210) 与较低的急诊率和急诊次数相关 (OR=0. 89,RR=0. 93,p< 0. 0001).
- 较高的CoC也与较低的住院病人的几率和数量相关 (OR=0. 85,RR=0. 89,p< 0. 0001).
- 死亡风险没有显著差异 (HHI风险比率=0. 99, p=0. 18).
结论:
- 在接受cBTKi治疗的CLL患者中,更高的护理连续性显著与急诊室访问和住院减少有关.
- 这些发现强调了血液学家/瘤学家对治疗CLL患者的持续护理的重要性.
- 虽然由于可追溯设计,无法推断因果关系,但结果表明保持CoC的潜在益处.
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