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心房颤动的疾病成本:一项关于社会影响的全国性研究。

Cost of illness of atrial fibrillation: a nationwide study of societal impact.

作者信息

Johnsen Søren Paaske, Dalby Lene Worsaae, Täckström Tomas, Olsen Jens, Fraschke Anina

机构信息

Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark.

Bayer Denmark, Copenhagen, Denmark.

出版信息

BMC Health Serv Res. 2017 Nov 10;17(1):714. doi: 10.1186/s12913-017-2652-y.

Abstract

BACKGROUND

The prevalence of atrial fibrillation is increasing rapidly; however, to date, population-based data are lacking on the attributable cost of illness of atrial fibrillation from a societal perspective, including both direct and indirect costs.

METHODS

The study was an incidence-based cost-of-illness study based on national registries covering the entire population of Denmark. We identified all patients with a first-time hospital diagnosis of atrial fibrillation between 2001 and 2012. For every atrial fibrillation patient, we identified three age- and sex-matched controls from the general population. Both the total and the attributable costs of atrial fibrillation were estimated based on individual level information on hospital care (in- and out-patient contacts), primary sector care, use of prescription drugs and productivity loss.

RESULTS

Average 3-year societal costs per patient attributable to atrial fibrillation were estimated to be €20,403-26,544 during the study period. The costs were highest during the first year after diagnosis of atrial fibrillation. Admission costs constituted the largest cost component, whereas primary sector costs and medicine costs only constituted minor components. The attributable costs were more than two-fold higher among patients experiencing a stroke. The total 3-year cost attributable to atrial fibrillation in Denmark was estimated to be €219-295 million.

CONCLUSIONS

The societal costs attributable to atrial fibrillation are significant. Reducing the need for hospitalizations, in particular from stroke, is a key factor in controlling the costs.

摘要

背景

心房颤动的患病率正在迅速上升;然而,迄今为止,从社会角度来看,缺乏关于心房颤动疾病归因成本的基于人群的数据,包括直接成本和间接成本。

方法

该研究是一项基于发病率的疾病成本研究,基于覆盖丹麦全体人口的国家登记数据。我们确定了2001年至2012年间首次在医院诊断为心房颤动的所有患者。对于每例心房颤动患者,我们从普通人群中确定了三名年龄和性别匹配的对照。心房颤动的总成本和归因成本是根据医院护理(住院和门诊接触)、初级部门护理、处方药使用和生产力损失的个体水平信息估算的。

结果

在研究期间,每例患者因心房颤动导致的平均3年社会成本估计为20403 - 26544欧元。成本在心房颤动诊断后的第一年最高。住院成本构成最大的成本组成部分,而初级部门成本和药品成本仅构成较小的组成部分。中风患者的归因成本高出两倍多。丹麦因心房颤动导致的3年总成本估计为2.19亿 - 2.95亿欧元。

结论

心房颤动导致的社会成本很高。减少住院需求,尤其是因中风导致的住院需求,是控制成本的关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1173/5681797/0e3e3813183b/12913_2017_2652_Fig1_HTML.jpg

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