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手术未满足需求的决定因素:跨导管大动脉置换的案例

Guy David¹, Jordan B Strom², Andrew J Epstein³

¹University of Pennsylvania, Philadelphia PA.

Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

|February 25, 2026

概括

跨导管大动脉置换 (TAVR) 接入的地理差距与大动脉狭窄患者的死亡率较高有关. 解决这些TAVR接入差异需要了解当地医疗保健能力和社会经济因素.

科学领域:

心血管医学心血管医学
医疗保健服务研究医疗服务研究
公共卫生公共卫生

背景情况:

大动脉狭窄 (AS) 是一种普遍的疾病,需要及时干预.
超导管大动脉置换 (TAVR) 是AS的关键治疗方法,但在地理位置上获得的治疗方法有所不同.
未得到满足的TAVR需求代表了心血管保健提供中的关键差距.

研究的目的:

调查美国各县未满足TAVR需求的决定因素.
评估TAVR接入缺口对AS的医疗保险受益者患者存活率的影响.
确定导致TAVR使用差异的因素.

主要方法:

开发一个县级TAVR不匹配得分,将程序率与估计需求进行比较.
县分为大都市,半城市和农村类别的分类.
对医疗保险数据 (2016-2022) 的分析,以确定与TAVR不匹配相关的因素及其与AS患者死亡率的相关性.

主要成果:

观察到TAVR交付的显著地理差异.
较高的TAVR不匹配得分与较少的TAVR医院,较低的市场度,更高的AS流行率和更低的收入相关.
更大的TAVR接入差距与死亡率的增加有关,特别是在半城市地区.

结论:

接入TAVR的差距与患者的治疗结果有关,并受到医疗保健能力,地理和社会经济因素的影响.
需要有针对性的干预措施来解决当地的TAVR接入差异.
改善TAVR护理提供需要针对面临接入挑战的地区量身定制的战略.

关键词:

访问访问访问访问访问地理变化地理变化在TAVRR中,我们可以看到.

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