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揭示一种隐形流行病:炎症性疾病及相关综合征早期诊断与治疗的临床及经济效益系统评价

Illuminating an Invisible Epidemic: A Systemic Review of the Clinical and Economic Benefits of Early Diagnosis and Treatment in Inflammatory Disease and Related Syndromes.

作者信息

Wylezinski Lukasz S, Gray Jamieson D, Polk Julia B, Harmata Andrew J, Spurlock Charles F

机构信息

Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.

IQuity, Inc., Nashville, TN 37203, USA.

出版信息

J Clin Med. 2019 Apr 11;8(4):493. doi: 10.3390/jcm8040493.

Abstract

Healthcare expenditures in the United States are growing at an alarming level with the Centers for Medicare and Medicaid Services (CMS) projecting that they will reach $5.7 trillion per year by 2026. Inflammatory diseases and related syndromes are growing in prevalence among Western societies. This growing population that affects close to 60 million people in the U.S. places a significant burden on the healthcare system. Characterized by relatively slow development, these diseases and syndromes prove challenging to diagnose, leading to delayed treatment against the backdrop of inevitable disability progression. Patients require healthcare attention but are initially hidden from clinician's view by the seemingly generalized, non-specific symptoms. It is imperative to identify and manage these underlying conditions to slow disease progression and reduce the likelihood that costly comorbidities will develop. Enhanced diagnostic criteria coupled with additional technological innovation to identify inflammatory conditions earlier is necessary and in the best interest of all healthcare stakeholders. The current total cost to the U.S. healthcare system is at least $90B dollars annually. Through unique analysis of financial cost drivers, this review identifies opportunities to improve clinical outcomes and help control these disease-related costs by 20% or more.

摘要

美国的医疗保健支出正以惊人的速度增长,医疗保险和医疗补助服务中心(CMS)预计到2026年,其年度支出将达到5.7万亿美元。炎症性疾病及相关综合征在西方社会的发病率正在上升。在美国,受这类疾病影响的人口接近6000万,给医疗保健系统带来了沉重负担。这些疾病和综合征发展相对缓慢,诊断颇具挑战性,在不可避免的残疾进展背景下导致治疗延误。患者需要医疗关注,但最初看似普遍、非特异性的症状使他们在临床医生眼中不易被察觉。识别和管理这些潜在病症对于减缓疾病进展以及降低出现代价高昂的合并症的可能性至关重要。加强诊断标准并辅以更多技术创新以更早识别炎症性病症很有必要,这符合所有医疗保健利益相关者的最佳利益。目前,美国医疗保健系统每年的总成本至少为900亿美元。通过对财务成本驱动因素的独特分析,本综述确定了改善临床结果的机会,并有助于将这些与疾病相关的成本控制20%或更多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/819f/6518102/5775f13e1b87/jcm-08-00493-g001.jpg

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