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丹麦 1998 年至 2016 年心力衰竭的经济负担。

The economic burden of heart failure in Denmark from 1998 to 2016.

机构信息

Department of Cardiology, Rigshospitalet, University Hospital, Copenhagen, Denmark.

Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.

出版信息

Eur J Heart Fail. 2019 Dec;21(12):1526-1531. doi: 10.1002/ejhf.1577. Epub 2019 Jul 29.

Abstract

BACKGROUND

Heart failure (HF) imposes a large burden on both the individual and the society. The aim of this study was to investigate the economic burden (either direct or indirect costs) attributed to patients with HF before, at, and after time of diagnosis.

METHODS AND RESULTS

Using Danish nationwide registries we identified all patients > 18 years with a first-time diagnosis of HF from 1998-2016 and matched them 1:1 with a control group from the background population on age, gender, marital status, and educational level. The economic analysis of the total costs after diagnosis was based on direct costs including hospitalization, procedures, medication, and indirect costs including social welfare and lost productivity to estimate the annual cost of HF. A total of 176 067 HF patients with a median age of 76 (interquartile range 67-84) years and 55% male were included. Patients with HF incurred an average of €17 039 in total annual direct (€11 926) and indirect (€5113) healthcare costs peaking at year of diagnosis compared to €5936 in the control group with the majority attributable to inpatient admissions. The total annual net costs including public transfer after index HF were €11 957 higher in patients with HF compared to controls and the economic consequences were evident more than 2 years prior to the diagnosis of HF.

CONCLUSION

Patients with HF impose significantly higher total annual healthcare costs compared to a matched control group with findings evident more than 2 years prior to HF diagnosis.

摘要

背景

心力衰竭(HF)给个人和社会都带来了沉重的负担。本研究旨在调查诊断前、诊断时和诊断后心力衰竭患者的经济负担(直接或间接成本)。

方法和结果

我们使用丹麦全国性登记处,确定了 1998 年至 2016 年期间首次诊断为 HF 的所有年龄在 18 岁以上的患者,并根据年龄、性别、婚姻状况和教育程度与背景人群中的对照组进行了 1:1 匹配。诊断后总费用的经济分析基于直接费用(包括住院、手术、药物)和间接费用(包括社会福利和生产力损失),以估计 HF 的年度成本。共纳入 176067 名 HF 患者,中位年龄为 76 岁(四分位间距 67-84 岁),男性占 55%。HF 患者的年平均总直接(€11926)和间接(€5113)医疗保健费用为€17039,在诊断年度达到峰值,而对照组的平均费用为€5936,主要归因于住院治疗。与对照组相比,HF 患者在指数 HF 后包括公共转移在内的年净费用高出€11957,并且在 HF 诊断前 2 年以上就已经显现出经济后果。

结论

与匹配的对照组相比,HF 患者的年总医疗保健费用明显更高,而且在 HF 诊断前 2 年以上就已经显现出这种情况。

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