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芬兰成人哮喘负担:疾病严重程度和嗜酸性粒细胞计数对医疗资源利用的影响。

The burden of adult asthma in Finland: impact of disease severity and eosinophil count on health care resource utilization.

机构信息

Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland.

Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.

出版信息

J Asthma. 2020 Oct;57(10):1092-1102. doi: 10.1080/02770903.2019.1633664. Epub 2019 Jul 3.

Abstract

To describe health care resource utilization (HCRU) and associated costs in adult patients referred for specialist asthma care in Southwest Finland, by disease severity and blood eosinophil count (BEC). This non-interventional, retrospective registry study (GSK ID: HO-17-17558) utilized data from patients >18 years of age on the hospital register of the Hospital District of Southwest Finland. Data extraction was from January 1, 2004 to December 31, 2015; the index date was the first hospital visit within this period with an International Classification of Diseases-10 diagnosis code for asthma or acute severe asthma. Patients were categorized by asthma severity (based on medication use) and BEC (<300 or ≥300 cells/μL). Total and asthma-related HCRU and estimated costs were recorded the year following index and for calendar years 2004-2015. Overall, 14,398 patients were included; 388 had severe asthma at index. BEC was available for 3781 patients; 1434 had a BEC ≥300 cells/μL and 2347 had a BEC <300 cells/μL. A total of 1241 patients had severe asthma; 270 patients had severe eosinophilic asthma (severe asthma and a BEC ≥300 cells/μL). Patients with severe versus non-severe asthma had higher total- and asthma-related outpatient visits, inpatient days, emergency room visits and costs per patient year; those with BEC ≥300 cells/μL versus <300 cells/μL had more outpatient visits. All recorded HCRU and associated costs were highest in patients with severe eosinophilic asthma. This study demonstrated a substantial burden associated with severe and/or eosinophilic asthma for adults in Finland.

摘要

描述在芬兰西南部接受专科哮喘护理的成年患者的健康保健资源利用(HCRU)和相关成本,根据疾病严重程度和血嗜酸性粒细胞计数(BEC)。这项非干预性、回顾性登记研究(GSK ID:HO-17-17558)利用了芬兰西南部地区医院登记处超过 18 岁患者的数据。数据提取时间为 2004 年 1 月 1 日至 2015 年 12 月 31 日;索引日期为该期间内首次就诊的日期,该日期有国际疾病分类-10 哮喘或急性重度哮喘的诊断代码。患者根据哮喘严重程度(基于药物使用)和 BEC(<300 或≥300 细胞/μL)进行分类。索引后一年和 2004-2015 年的日历年内记录了总 HCRU 和哮喘相关 HCRU 和估计成本。共有 14398 名患者纳入研究;388 名患者在索引时有重度哮喘。3781 名患者可获得 BEC 数据;1434 名患者的 BEC≥300 细胞/μL,2347 名患者的 BEC<300 细胞/μL。共有 1241 名患者有重度哮喘;270 名患者有重度嗜酸性粒细胞性哮喘(重度哮喘和 BEC≥300 细胞/μL)。与非重度哮喘患者相比,重度哮喘患者的总 HCRU 和哮喘相关门诊就诊、住院天数、急诊就诊和患者每年成本均较高;BEC≥300 细胞/μL 的患者比 BEC<300 细胞/μL 的患者门诊就诊次数更多。在芬兰,重度和/或嗜酸性粒细胞性哮喘患者的所有记录 HCRU 和相关成本均最高。这项研究表明,芬兰成年人的重度和/或嗜酸性粒细胞性哮喘负担很大。

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