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[胃食管反流病的卫生资源利用及生产力损失:西班牙基层医疗环境下的一项横断面研究结果]

[Use of health resources and loss of productivity in gastroesophageal reflux disease: results of a cross-sectional study in a primary care setting in Spain].

作者信息

Nuevo Javier, Tafalla Mónica, Zapardiel Javier, Gisbert J P

机构信息

Departamento Médico, AstraZeneca Farmacéutica Spain, S.A., España.

出版信息

Aten Primaria. 2011 Sep;43(9):474-81. doi: 10.1016/j.aprim.2010.09.009. Epub 2011 Mar 5.

Abstract

OBJECTIVE

To evaluate healthcare resource use and productivity in patients with gastro-esophageal reflux disease (GERD) and the influence of disease severity on these two factors.

DESIGN

Sub-analysis of the Spanish population of a multinational study with a 4-month retrospective period for the identification and selection of patients, and a clinical visit to obtain clinical information and data on use of healthcare resources, carried out between October 2007 and January 2008.

POPULATION

A total of 477 patients attending a Primary Care centre, with a medical consultation for GERD.

MAIN VARIABLES

Use of healthcare resources, changes in productivity based on the Work Productivity and Activity Impairment Questionnaire for GERD patients (WPAI-GERD).

RESULTS

Despite having received pharmacological treatment at the baseline visit, after a median of 5.1 months follow-up (range 2.1-8.1), up to 15.9% (95% CI; 12.8-19.5) patients still showed clinically relevant GERD symptoms. Direct medical costs per year associated with diagnostic tests and medical consultations in patients with or without clinically relevant GERD symptoms were 666 € (SD: 2,097 €) and 370 € (SD: 2,060 €), respectively. The mean annual cost of reduced productivity (17%) was 5,316 € (SD: 8,615 €). This cost was 4 times higher for patients with clinically relevant GERD symptoms than for patients with no relevant symptoms (15,188 € [SD: 11,206 €] vs 3,926 € [SD: 7,232 €]).

CONCLUSION

Patients with GERD use significant healthcare resources, attributable to associated medical costs and marked reduction in productivity, even though they receive pharmacological treatment.

摘要

目的

评估胃食管反流病(GERD)患者的医疗资源使用和生产力情况,以及疾病严重程度对这两个因素的影响。

设计

对一项跨国研究的西班牙人群进行亚分析,回顾期为4个月,用于识别和选择患者,并进行临床访视以获取临床信息和医疗资源使用数据,研究于2007年10月至2008年1月进行。

研究对象

共有477名到初级保健中心就诊并因GERD接受医疗咨询的患者。

主要变量

医疗资源的使用,基于GERD患者工作生产力和活动障碍问卷(WPAI-GERD)的生产力变化。

结果

尽管在基线访视时已接受药物治疗,但在中位随访5.1个月(范围2.1 - 8.1个月)后,仍有高达15.9%(95%CI:12.8 - 19.5)的患者表现出具有临床意义的GERD症状。有或无临床意义的GERD症状的患者每年与诊断测试和医疗咨询相关的直接医疗费用分别为666欧元(标准差:2,097欧元)和370欧元(标准差:2,060欧元)。生产力下降的平均年度成本(17%)为5,316欧元(标准差:8,615欧元)。有临床意义的GERD症状的患者的这一成本比无相关症状的患者高4倍(15,188欧元[标准差:11,206欧元]对3,926欧元[标准差:7,232欧元])。

结论

GERD患者使用大量医疗资源,这归因于相关的医疗费用和生产力的显著下降,即使他们接受了药物治疗。

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Clinical practice. Gastroesophageal reflux disease.临床实践。胃食管反流病。
N Engl J Med. 2008 Oct 16;359(16):1700-7. doi: 10.1056/NEJMcp0804684.

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