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利培酮长效注射剂起始治疗前后芬兰精神分裂症患者的住院利用情况及费用

Hospitalisation Utilisation and Costs in Schizophrenia Patients in Finland before and after Initiation of Risperidone Long-Acting Injection.

作者信息

Asseburg Christian, Willis Michael, Löthgren Mickael, Seppälä Niko, Hakala Mika, Persson Ulf

机构信息

ESiOR Oy, Tulliportinkatu 2, 70100 Kuopio, Finland.

出版信息

Schizophr Res Treatment. 2012;2012:791468. doi: 10.1155/2012/791468. Epub 2012 May 7.

Abstract

Objectives. Quantify changes in hospital resource use in Finland following initiation of risperidone long-acting injection (RLAI). Materials and Methods. A retrospective multi-center chart review (naturalistic setting) was used to compare annual hospital bed-days and hospital episodes for 177 schizophrenia patients (mean age 47.1 years, 52% female, 72% hospitalized) before and after initiation of RLAI (between January 2004 and June 2005) using the within-patient "mirror-image" study design. The base case analytical approach allocated hospital episodes overlapping the start date entirely to the preinitiation period. In order to investigate the impact of inpatient care ongoing at baseline, the change in bed-days was also estimated using an alternative analytical approached related to economic modelling. Results. In the conventional analysis, the mean annual hospitalisation costs declined by €11,900 and the number of bed-days was reduced by 40%, corresponding to 0.19 fewer hospital episodes per year. The reductions in bed-days per patient-year were similar for patients switched to RLAI as inpatients and as outpatients. In the modelling-based analysis, an 8% reduction in bed-days per year was observed. Conclusion. Despite uncertainty in the choice of analytic approach for allocating inpatient episodes that overlapping this initiation, consistent reductions in resource use are associated with the initiation of RLAI in Finland.

摘要

目的。量化在芬兰开始使用利培酮长效注射剂(RLAI)后医院资源使用情况的变化。材料与方法。采用回顾性多中心病历审查(自然环境),使用患者内“镜像”研究设计,比较177例精神分裂症患者(平均年龄47.1岁,52%为女性,72%曾住院)在开始使用RLAI之前和之后(2004年1月至2005年6月)的年度住院天数和住院次数。基础病例分析方法将与开始日期重叠的住院次数完全分配到开始使用RLAI之前的时期。为了研究基线时正在进行的住院治疗的影响,还使用了一种与经济建模相关的替代分析方法来估计住院天数的变化。结果。在传统分析中,平均每年住院费用下降了11,900欧元,住院天数减少了40%,相当于每年住院次数减少0.19次。转为接受RLAI治疗的住院患者和门诊患者每年每人住院天数的减少情况相似。在基于模型的分析中,观察到每年住院天数减少8%。结论。尽管在分配与开始使用RLAI重叠的住院次数的分析方法选择上存在不确定性,但在芬兰,开始使用RLAI与资源使用的持续减少相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047e/3420409/338a684c41ee/SPRT2012-791468.001.jpg

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