Sicras-Mainar Antoni, Navarro-Artieda Ruth, Sáez-Zafra Marc
Dirección Científica, ClinicResearch, Tiana, Barcelona, España.
Documentación Médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
Gastroenterol Hepatol. 2018 Apr;41(4):234-244. doi: 10.1016/j.gastrohep.2017.11.008. Epub 2017 Dec 26.
To assess the comorbidity, concomitant medications, healthcare resource use and healthcare costs of chronic hepatitis C virus patients in the Spanish population.
Retrospective, observational, non-interventional study. Patients included were≥18 years of age who accessed medical care between 2010-2013. Patients were divided into 2 groups based on the presence or absence of liver cirrhosis. The follow-up period was 12 months. Main assessment criteria included general comorbidity level (determined by the resource utilisation band score) and prevalence of specific comorbidities, concomitant medications, healthcare resource use and healthcare costs. Statistical analysis was performed using regression models and ANCOVA, P<.05.
One thousand fifty-five patients were enrolled, the mean age was 57.9 years and 55.5% were male. A percentage of 43.5 of patients had a moderate level of comorbidity according to the resource utilisation band score. The mean time from diagnosis was 18.1 years and 7.5% of the patients died during the follow-up period. The most common comorbidities were dyslipidaemia (40.3%), hypertension (40.1%) and generalised pain (38.1%). Cirrhosis was associated with cardiovascular events (OR 3.8), organ failures (OR 2.2), alcoholism (OR 2.1), diabetes (OR 1.2) and age (OR 1.2); P<.05. The most commonly used medications were anti-infectives (67.8%) and nervous system medications (66.8%). The mean total cost per patient was 3,198€ (71.5% healthcare costs, 28.5% indirect/non-healthcare costs). In the corrected model, the total costs per patient-year were 2,211€ for those without cirrhosis and 7,641€ for patients with cirrhosis; P<.001.
Chronic hepatitis C virus patients are associated with a high level of comorbidity and the use of concomitant medications, especially in patients with liver cirrhosis. Chronic hepatitis C virus infection represents a substantial economic burden on the Spanish National Health System.
评估西班牙人群中慢性丙型肝炎病毒患者的合并症、伴随用药情况、医疗资源使用情况及医疗费用。
回顾性、观察性、非干预性研究。纳入的患者年龄≥18岁，于2010年至2013年期间接受医疗护理。根据是否存在肝硬化将患者分为两组。随访期为12个月。主要评估标准包括总体合并症水平（由资源利用频段评分确定）和特定合并症的患病率、伴随用药情况、医疗资源使用情况及医疗费用。使用回归模型和协方差分析进行统计分析，P<0.05。
共纳入1055例患者，平均年龄为57.9岁，55.5%为男性。根据资源利用频段评分，43.5%的患者合并症水平为中度。从诊断到纳入研究的平均时间为18.1年，7.5%的患者在随访期间死亡。最常见的合并症为血脂异常（40.3%）、高血压（40.1%）和全身疼痛（38.1%）。肝硬化与心血管事件（比值比3.8）、器官衰竭（比值比2.2）、酒精中毒（比值比2.1）、糖尿病（比值比1.2）和年龄（比值比1.2）相关；P<0.05。最常用的药物为抗感染药（67.8%）和神经系统药物（66.8%）。每位患者的平均总费用为3198欧元（医疗费用占71.5%，间接/非医疗费用占28.5%）。在校正模型中，无肝硬化患者的每位患者每年总费用为2211欧元，肝硬化患者为7641欧元；P<0.001。
慢性丙型肝炎病毒患者合并症水平高且使用伴随用药，尤其是肝硬化患者。慢性丙型肝炎病毒感染给西班牙国家卫生系统带来了巨大的经济负担。
