a Division of Clinical Neurosciences , Turku University Hospital , Turku , Finland.
b Department of Neurology , University of Turku , Turku , Finland.
Ann Med. 2018 Jun;50(4):354-360. doi: 10.1080/07853890.2018.1461919. Epub 2018 Apr 17.
Treatment of multiple sclerosis (MS) has developed significantly and several new immunotherapeutic drugs have become available in Finland since 2004. We studied whether this is associated with changes in hospital admission frequencies and healthcare costs and whether admission rates due to infection have increased.
The national Care Register for Health Care was searched for all discharges from neurological, medical, surgical, neurosurgical and intensive care units with MS as a primary diagnosis or an auxiliary diagnosis for primary infection diagnosis in 2004-2014. Only patients ≥16 years of age were included.
We identified 12,276 hospital admissions for 4296 individuals. The number of admissions declined by 4.6% annually (p = .0024) in both genders. Proportion of admissions with an infection as the primary diagnosis increased but no change in their frequency was found. They were longer than admissions with MS as the primary diagnosis and were associated with increased in-hospital mortality. The annual aggregate cost of hospital admissions declined by 51% during the study period.
This study shows that hospital admission rates and costs related to MS hospital admissions have markedly declined from 2004 to 2014 in Finland, which coincides with an increase in the use of disease-modifying therapies. Key message Hospital admission rates and costs related to MS hospital admissions have markedly declined from 2004 to 2014 in Finland. Proportion of admission related to infection has increased and they are associated with longer hospitalizations and increased in-hospital mortality pointing out the importance of infection prevention.
自 2004 年以来，多发性硬化症（MS）的治疗方法已有了显著的发展，芬兰也有几种新的免疫治疗药物可供使用。我们研究了这是否与住院频率和医疗保健费用的变化有关，以及是否因感染而导致的入院率增加。
在 2004 年至 2014 年期间，通过国家医疗保健注册中心，对所有因 MS 作为主要诊断或原发性感染诊断的辅助诊断而从神经科、内科、外科、神经外科和重症监护病房出院的患者进行了搜索。仅纳入年龄≥16 岁的患者。
我们确定了 4296 名患者中的 12276 例住院。男女两性的住院人数每年减少 4.6%（p=0.0024）。以感染为主要诊断的住院人数比例有所增加，但频率未发现变化。他们比以 MS 为主要诊断的住院时间更长，与住院死亡率增加有关。在研究期间，住院总费用每年下降 51%。
本研究表明，2004 年至 2014 年期间，芬兰与 MS 住院相关的住院率和费用显著下降，这与疾病修正疗法的使用增加有关。关键信息：2004 年至 2014 年期间，芬兰与 MS 住院相关的住院率和费用显著下降。与感染相关的入院比例增加，且与住院时间延长和住院死亡率增加有关，这突出了感染预防的重要性。
