College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea.
Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
PLoS One. 2018 Dec 21;13(12):e0208731. doi: 10.1371/journal.pone.0208731. eCollection 2018.
The prevalence of heart failure (HF) and its economic burden are increasing with age of the South Korean population. This study aimed to assess the economic impact of HF from the societal perspective.
A prevalence-based, incremental cost-of-patient study was performed to estimate the cost ratio between patients with HF and those without HF based on the claims database of the national health insurance in South Korea. We defined adult HF patients as those aged ≥19 years who had at least one insurance claim record with a primary or secondary diagnosis of HF. Age- and gender-matched controls were defined using a 1:4 greedy matching method. Costs were estimated by including medical costs for insurance-covered and non-covered services, transportation costs, caregiver's cost, and time costs of patients. The ratio of costs between patients with HF and those without HF was adjusted for age, gender, and type of universal health security program in the multivariate regression model.
The average annual per-capita cost was estimated to be $6,601 for patients with HF (n = 14,252), which is about 3.38 (95% confidence interval [CI]: 3.31-3.46) times higher than that for patients without HF (n = 1,116,882) and 1.64 (95% CI: 1.59-1.70) times higher than that for the age- and gender-matched patients without HF (n = 57,008). In the multivariate regression model, the annual per-capita total costs were 1.98-fold (95% CI: 1.94-2.02) statistically higher for patients with HF than for patients without HF after adjustment for age, gender, and type of universal health security program.
This study demonstrates a significant incremental burden of HF. Given that the prevalence of HF is expected to increase with an increase in the aging population, the national economic burden is expected to be substantial in the future. Thus, greater emphasis on the prevention and treatment of HF is warranted.
随着韩国人口老龄化，心力衰竭（HF）的患病率及其经济负担不断增加。本研究旨在从社会角度评估 HF 的经济影响。
本研究采用基于患病率的增量患者成本研究，根据韩国国家健康保险的索赔数据库，根据 HF 患者和非 HF 患者的索赔记录，评估 HF 患者的成本比。我们将成年 HF 患者定义为年龄≥19 岁，至少有一次 HF 的主要或次要诊断的保险索赔记录。采用 1:4 贪婪匹配方法定义年龄和性别匹配的对照组。通过包含保险覆盖和非覆盖服务的医疗费用、交通费用、护理人员费用和患者的时间成本来估计成本。在多变量回归模型中，根据年龄、性别和全民健康安全计划类型调整 HF 患者与非 HF 患者之间的成本比。
估计 HF 患者（n=14252）的人均年费用为 6601 美元，是非 HF 患者（n=1116882）的 3.38 倍（95%置信区间[CI]：3.31-3.46），是年龄和性别匹配的非 HF 患者（n=57008）的 1.64 倍（95% CI：1.59-1.70）。在多变量回归模型中，在调整年龄、性别和全民健康安全计划类型后，HF 患者的人均年总费用比非 HF 患者高 1.98 倍（95% CI：1.94-2.02）。
本研究表明 HF 负担显著增加。鉴于 HF 的患病率预计会随着人口老龄化的增加而增加，未来国家的经济负担预计会很大。因此，更需要重视 HF 的预防和治疗。
