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北马其顿血液透析血管接入的战略和成本分析
Nikola Gjorgjievski1, Vlatko Karanfiovski1, Petar Dejanov1
1University Clinic of Nephrology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia.
Jornal vascular brasileiro
|January 23, 2026
概括
北马其顿的血管接入实践显示,动脉静脉 (AVF) 的增加,但在透析开始时大量使用临时中央静脉导管 (CVC). 优化AVF使用和长期规划可以改善结果并降低成本.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血管外科 血管外科
- 卫生经济学 卫生经济学
背景情况:
- 血管接入 (VA) 对于血液透析 (HD) 是至关重要的.
- 动脉静脉 (AVF) 提供了比中央静脉导管 (CVC) 更好的结果.
- 在全球范围内,VA的做法有所不同.
研究的目的:
- 为了分析20年来在北马其顿使用的VA类型的趋势.
- 评估VA程序的相关成本和财务影响.
- 确定VA战略需要改进的领域.
主要方法:
- 在斯科普耶大学脏病诊所对VA手术 (2002-2023) 的回顾性审查.
- 收集关于AVF,道中央导管 (TCC) 和临时CVC的数据.
- 使用诊断相关组 (DRG) 编码进行成本分析.
主要成果:
- 进行了超过25,000次VA手术,其中大多数是临时的CVC (18,535).
- AVF的使用量稳步增加,在2020年由于COVID-19而导致的下降.
- 由于CVC费用,VA费用从诊所预算 (2018-2022) 的6.6%上升到9.3%,主要是CVC费用.
结论:
- 北马其顿在透析开始时暂时使用CVC的比例仍然很高.
- 建议增加预防性AVF放置.
- 增强的长期VA规划对于更好的患者结果和降低成本至关重要.
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