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急性心力衰竭事件后心力衰竭患者的医疗费用:一年随访研究

Medical costs in patients with heart failure after acute heart failure events: one-year follow-up study.

作者信息

Kim Eugene, Kwon Hye-Young, Baek Sang Hong, Lee Haeyoung, Yoo Byung-Su, Kang Seok-Min, Ahn Youngkeun, Yang Bong-Min

机构信息

a Graduate School of Public Health , Seoul National University , Seoul , South Korea.

b Division of Biology & Public Health , Mokwon University , Daejeon , South Korea.

出版信息

J Med Econ. 2018 Mar;21(3):288-293. doi: 10.1080/13696998.2017.1403922. Epub 2017 Nov 28.

Abstract

AIMS

This study investigated annual medical costs using real-world data focusing on acute heart failure.

METHODS

The data were retrospectively collected from six tertiary hospitals in South Korea. Overall, 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. Data were collected on their follow-up medical visits for 1 year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded. Annual per patient medical costs were estimated according to the type of medical services, and factors contributing to the costs using Gamma Generalized Linear Models (GLM) with log link were analyzed.

RESULTS

On average, total annual medical costs for each patient were USD 6,199 (±9,675), with hospitalization accounting for 95% of the total expenses. Hospitalization cost USD 5,904 (±9,666) per patient. Those who are re-admitted have 88.5% higher medical expenditure than those who have not been re-admitted in 1 year, and patients using intensive care units have 19.6% higher expenditure than those who do not. When the number of hospital days increased by 1 day, medical expenses increased by 6.7%.

LIMITATIONS

Outpatient drug costs were not included. There is a possibility that medical expenses for AHF may have been under-estimated.

CONCLUSION

It was found that hospitalization resulted in substantial costs for treatment of heart failure in South Korea, especially in patients with an acute heart failure event. Prevention strategies and appropriate management programs that would reduce both frequency of hospitalization and length of stay for patients with the underlying risk of heart failure are needed.

摘要

目的

本研究使用聚焦于急性心力衰竭的真实世界数据调查年度医疗费用。

方法

数据回顾性收集自韩国的六家三级医院。总体上,选取了2011年1月至2012年7月期间因急性心力衰竭住院的330例患者。收集了他们1年的随访医疗就诊数据,包括治疗产生的医疗费用。排除了在观察期内死亡或无随访就诊记录的患者。根据医疗服务类型估算每位患者的年度医疗费用,并使用带有对数链接的伽马广义线性模型(GLM)分析导致费用的因素。

结果

平均而言,每位患者的年度总医疗费用为6199美元(±9675美元),其中住院费用占总费用的95%。每位患者的住院费用为5904美元(±9666美元)。再次入院的患者比1年内未再次入院的患者医疗支出高88.5%,使用重症监护病房的患者比未使用者支出高19.6%。住院天数每增加1天,医疗费用增加6.7%。

局限性

未包括门诊药物费用。急性心力衰竭的医疗费用可能被低估。

结论

研究发现,在韩国,住院导致心力衰竭治疗产生大量费用,尤其是在发生急性心力衰竭事件的患者中。需要制定预防策略和适当的管理方案,以减少有心力衰竭潜在风险患者的住院频率和住院时间。

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