Farkowski Michal M, Pytkowski Mariusz, Maciag Aleksander, Golicki Dominik, Kowalik Ilona, Czech Marcin, Rucinski Piotr, Szwed Hanna
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1 St., 02-637, Warsaw, Poland.
Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
J Interv Card Electrophysiol. 2016 Nov;47(2):197-202. doi: 10.1007/s10840-016-0167-9. Epub 2016 Aug 3.
Radiofrequency ablation (RFA) is considered the treatment of choice in cases of atrioventricular nodal reciprocating tachycardia (AVNRT) and atrioventricular reciprocating tachycardia (AVRT). Published studies suggest a considerable time gap between the onset of the arrhythmia, correct diagnosis, and RFA which may reach 10-15 years. The cost of medical treatment during that period may be substantial. The aim of the study was to calculate the annual direct medical cost of medical treatment of patients with AVNRT and AVRT and identify potential factors influencing this cost.
Based on the consumption of particular resources and the unit costs of services in 2013, we calculated the annual direct medical cost of care for patients with AVNRT and AVRT in Poland. We adopted the public payer's and societal perspectives. Data on health resources was collected with a structured questionnaire and medical records of patients scheduled for RFA. Additional analyses were performed to identify factors influencing this cost.
We enrolled 82 patients: mean age 43.9 ± 14.1 years old and mean symptom duration before the RFA 13.0 ± 11.3 years. The median annual cost of medical treatment was 546 USD [312-957], 411 € [278-786], and 616 USD [369-1044], 464 € [235-721], for the public payer and the common perspective, respectively, with hospitalizations being the main cost component. In multivariate analysis, only the age of the patient significantly influenced this cost.
The annual cost of medical treatment of AVNRT or AVRT is substantial and dependent on the age of the patient rather than the severity of the arrhythmia (NCT01594814).
射频消融术(RFA)被认为是房室结折返性心动过速(AVNRT)和房室折返性心动过速(AVRT)病例的首选治疗方法。已发表的研究表明,从心律失常发作到正确诊断以及进行RFA之间存在相当长的时间间隔,可能长达10 - 15年。在此期间的医疗费用可能相当可观。本研究的目的是计算AVNRT和AVRT患者的年度直接医疗费用,并确定影响该费用的潜在因素。
基于2013年特定资源的消耗和服务的单位成本,我们计算了波兰AVNRT和AVRT患者的年度直接医疗护理费用。我们采用了公共支付者和社会的视角。通过结构化问卷和计划接受RFA患者的病历收集健康资源数据。进行了额外的分析以确定影响该费用的因素。
我们纳入了82例患者:平均年龄43.9±14.1岁,RFA前平均症状持续时间13.0±11.3年。对于公共支付者和总体视角,年度医疗费用中位数分别为546美元[312 - 957]、411欧元[278 - 786]以及616美元[369 - 1044]、464欧元[235 - 721],住院是主要成本组成部分。在多变量分析中,只有患者年龄对该费用有显著影响。
AVNRT或AVRT的年度医疗费用相当可观,且取决于患者年龄而非心律失常的严重程度(NCT01594814)。