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接受抗凝治疗的非瓣膜性心房颤动患者的每日住院费用。

Daily costs of hospitalization in non-valvular atrial fibrillation patients treated with anticoagulant therapy.

作者信息

Dasta Joseph F, Pilon Dominic, Mody Samir H, Lopatto Jessica, Laliberté François, Germain Guillaume, Bookhart Brahim K, Lefebvre Patrick, Nutescu Edith A

机构信息

a a University of Texas College of Pharmacy , Round Rock , TX , USA.

b b Groupe d'analyse, Ltée , Montréal , QC , Canada.

出版信息

J Med Econ. 2015;18(12):1041-9. doi: 10.3111/13696998.2015.1074583. Epub 2015 Aug 26.

Abstract

BACKGROUND

Atrial fibrillation (AF) is the most common cardiac rhythm disturbance in the US, with an estimated prevalence of 2.7-6.1 million persons in 2010.

OBJECTIVE

This study evaluates the progression of daily hospitalization costs among non-valvular atrial fibrillation (NVAF) patients treated with anticoagulant therapy.

METHODS

A claims analysis was conducted with Premier Perspective Comparative Hospital Database records from January 2009-March 2013. Patients of 18 years or older who were diagnosed with NVAF and used anticoagulant therapy were studied. Treatment patterns and mean daily costs of hospitalization per patient as well as total costs of hospitalization were reported. Comparisons of mean daily costs with those of the previous day were presented to identify statistical cost differences between hospitalization days.

RESULTS

A total of 375,560 patients were identified; 67,017 with AF as admitting/primary diagnosis, and 308,543 with AF as a secondary diagnosis. The mean age of the overall population, primary AF diagnosis cohort, and secondary AF diagnosis cohort was 73.8, 67.9, and 75.0 years, while their proportion of females was 46.3%, 45.6%, and 46.5%, respectively. The mean length of stay was 6.8 days, 3.7 days, and 7.5 days for the overall population, the primary AF diagnosis cohort, and the secondary AF diagnosis cohort, respectively. For all cohorts, mean daily costs stabilized on the third day (overall population: $2103; primary AF diagnosis cohort: $1505; secondary AF diagnosis cohort: $2208).

LIMITATIONS

Claims data may have contained inaccuracies or omissions in coded procedures, diagnoses, or pharmacy claims.

CONCLUSION

The study showed that daily hospitalization costs for NVAF patients stabilized on the third day of hospitalization and that any reduction or prolongation in hospital length of stay could have a significant impact on the cost burden associated with AF.

摘要

背景

在美国,心房颤动(AF)是最常见的心律失常,2010年估计患病率为270万至610万人。

目的

本研究评估接受抗凝治疗的非瓣膜性心房颤动(NVAF)患者每日住院费用的变化情况。

方法

利用Premier Perspective Comparative Hospital Database数据库2009年1月至2013年3月的记录进行索赔分析。研究对象为年龄在18岁及以上、被诊断为NVAF并接受抗凝治疗的患者。报告了治疗模式、每位患者的平均每日住院费用以及住院总费用。对每日平均费用与前一天的费用进行比较,以确定住院天数之间的统计学成本差异。

结果

共识别出375,560例患者;其中67,017例以AF作为入院/主要诊断,308,543例以AF作为次要诊断。总体人群、原发性AF诊断队列和继发性AF诊断队列的平均年龄分别为73.8岁、67.9岁和75.0岁,女性比例分别为46.3%、45.6%和46.5%。总体人群、原发性AF诊断队列和继发性AF诊断队列的平均住院时间分别为6.8天、3.7天和7.5天。对于所有队列,平均每日费用在第三天趋于稳定(总体人群:2103美元;原发性AF诊断队列:1505美元;继发性AF诊断队列:2208美元)。

局限性

索赔数据可能在编码程序、诊断或药房索赔方面存在不准确或遗漏。

结论

该研究表明,NVAF患者的每日住院费用在住院第三天趋于稳定,住院时间的任何缩短或延长都可能对与AF相关的成本负担产生重大影响。

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