Tran Dat T, Ohinmaa Arto, Thanh Nguyen X, Welsh Robert C, Kaul Padma
School of Public Health, University of Alberta, Edmonton, AB, Canada.
Canadian VIGOUR Centre, University of Alberta, 2-132 Li Ka Shing Centre, Edmonton, AB, Canada.
Pharmacoecon Open. 2018 Dec;2(4):433-442. doi: 10.1007/s41669-017-0061-0.
Little is known about the cost burden of acute myocardial infarction (AMI) on healthcare systems. Accordingly, we examined the long-term trends of healthcare costs for AMI in the province of Alberta, Canada.
We linked five Albertan health databases, including ambulatory care, hospitalization, practitioner claims, pharmaceutical information network, and population registry to identify patients with a primary diagnosis of AMI between 2004 and 2013. We used the Alberta Interactive Health Data Application to provide unit costs for ambulatory care and inpatient services, claim paid amounts for physician services, and the Alberta Drug Benefit List for drug prices. Healthcare costs for AMI were grouped into ambulatory care, hospitalization, physician costs, and drug costs. All costs were converted to 2016 Canadian dollar values ($Can).
A total of 52,912 patients with AMI were included in the analysis. Patient age decreased over time, as did the proportion of females. AMI cost the Alberta healthcare system Can$1033 million during the study period; of which the largest proportion was hospitalization costs (Can$716.4 million, 63.1%), followed by drug costs (Can$147.2 million, 21.1%), ambulatory care costs (Can$94.5 million, 8.8%) and physician costs (Can$74.9 million, 7.0%). The cost per AMI hospitalization decreased from Can$14,116 in 2004 to Can$11,792 in 2013 (p < 0.001).
Healthcare costs for AMI are significant; however, they decreased slightly during the study period. Hospital services accounted for the largest share of the costs. There are opportunities for further savings in AMI care.
关于急性心肌梗死（AMI）给医疗系统带来的成本负担，人们了解甚少。因此，我们研究了加拿大艾伯塔省AMI医疗成本的长期趋势。
我们将五个艾伯塔省的健康数据库相链接，包括门诊护理、住院治疗、从业者索赔、药品信息网络和人口登记处，以识别2004年至2013年间初次诊断为AMI的患者。我们使用艾伯塔省交互式健康数据应用程序来提供门诊护理和住院服务的单位成本、医生服务的索赔支付金额以及药品价格的艾伯塔省药品福利清单。AMI的医疗成本分为门诊护理、住院治疗、医生成本和药品成本。所有成本均换算为2016年加拿大元价值（加元）。
共有52,912例AMI患者纳入分析。患者年龄随时间下降，女性比例也下降。在研究期间，AMI给艾伯塔省医疗系统造成了10.33亿加元的成本；其中最大比例是住院成本（7.164亿加元，63.1%），其次是药品成本（1.472亿加元，21.1%）、门诊护理成本（9450万加元，8.8%）和医生成本（7490万加元，7.0%）。每例AMI住院成本从2004年的14,116加元降至2013年的11,792加元（p<0.001）。
AMI的医疗成本很高；然而，在研究期间略有下降。医院服务占成本的最大份额。在AMI护理方面有进一步节约成本的机会。
