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在临床实践环境中,心肌梗死后的长期资源使用模式和医疗保健成本:来自当代全国性注册研究的结果。

Long-term resource use patterns and healthcare costs after myocardial infarction in a clinical practice setting: results from a contemporary nationwide registry study.

机构信息

Department of Cardiology, Linköping University, SE-58185 Linköping, Sweden.

Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.

出版信息

Eur Heart J Qual Care Clin Outcomes. 2016 Oct 1;2(4):291-298. doi: 10.1093/ehjqcco/qcw019.

Abstract

AIMS

Long-term contemporary nationwide data on resource use and healthcare costs after myocardial infarction (MI) in a clinical practice setting are not widely studied, and the aim of this study was to investigate resource use patterns and healthcare costs in patients with MI in a nationwide clinical practice setting.

METHODS AND RESULTS

This retrospective cohort study included all patients identified in the compulsory Swedish nationwide patient register with a diagnosis of MI between 1 July 2006 and 30 June 2011. Cardiovascular hospitalization and outpatient visits data from the patient register were combined with data from the cause of death register and the drug utilization register. For a subset of patients, data were also available from a primary care register. Healthcare resource use patterns and annual costs [reported in 2014 euros (€) converted from Swedish kronor (SEK) using the exchange rate €1 = SEK 9.33)] were estimated for the year prior to the occurrence of MI as well as for a maximum follow-up period of 6 years post-MI. The study included 97 252 patients with a diagnosis of MI with a total number of 285 351 observation years. The majority of healthcare consumption occurred within the first year of MI where patients were on average hospitalized 1.55 times, made 1.08 outpatient care visits, and 3.80 primary care visits. In the long term, for the majority of resource use categories, average consumption was higher in the years after MI compared with the year prior to MI. Healthcare costs at 6 years of follow-up were approximately €20 000 of which €12 460 occurred in the first year, and the major part was attributed to hospitalizations.

CONCLUSION

For patients with 6 years of follow-up after MI, healthcare costs were approximately €20 000. The major part of costs occurred in the first year after MI and was driven by hospitalizations.

CLINICALTRIALS.GOV IDENTIFIER: NCT01984307.

摘要

目的

在临床实践环境中,关于心肌梗死(MI)后资源利用和医疗保健成本的长期当代全国性数据尚未广泛研究,本研究旨在调查全国临床实践环境中 MI 患者的资源利用模式和医疗保健成本。

方法和结果

本回顾性队列研究纳入了 2006 年 7 月 1 日至 2011 年 6 月 30 日期间在瑞典强制性全国患者登记册中诊断为 MI 的所有患者。从患者登记册中获取心血管住院和门诊就诊数据,并与死因登记册和药物利用登记册中的数据相结合。对于一部分患者,还可以从初级保健登记册中获得数据。在 MI 发生前一年以及 MI 后最长 6 年的随访期间,估计了 MI 前一年以及 MI 后 6 年的医疗保健资源利用模式和年度成本(以 2014 年欧元(€)报告,使用汇率€1=SEK9.33 将瑞典克朗(SEK)换算而来)。该研究纳入了 97252 例 MI 诊断患者,共观察了 285351 年。大多数医疗保健消费发生在 MI 发生后的第一年,患者平均住院 1.55 次,门诊就诊 1.08 次,初级保健就诊 3.80 次。在长期内,对于大多数资源利用类别,MI 后多年的平均消费高于 MI 前一年。6 年随访时的医疗保健费用约为 20000 欧元,其中 12460 欧元发生在第一年,大部分归因于住院治疗。

结论

对于 MI 后 6 年随访的患者,医疗保健费用约为 20000 欧元。大部分费用发生在 MI 后第一年,主要由住院治疗引起。

临床试验.gov 标识符:NCT01984307。

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