Department of Medicine, The University of Melbourne at St Vincent's Hospital (Melbourne), 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia.
Department of Rheumatology, St Vincent's Hospital (Melbourne), 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia.
BMC Pulm Med. 2019 Nov 27;19(1):226. doi: 10.1186/s12890-019-0989-1.
To quantify the financial cost of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc).
Healthcare use was captured through data linkage, wherein clinical data for SSc patients enrolled in the Australian Scleroderma Cohort Study were linked with hospital, emergency department (ED) and ambulatory care databases (MBS) for the period 2008-2015. PAH was diagnosed on right heart catheter according to international criteria. Determinants of healthcare cost were estimated using logistic regression.
Total median (25th-75th) healthcare cost per patient (including hospital, ED and MBS cost but excluding medication cost) for our cohort during 2008-2015 was AUD$37,685 (18,144-78,811) with an annual per patient healthcare cost of AUD$7506 (5273-10,654). Total healthcare cost was higher for SSc-PAH patients compared with those without PAH with a total cost per patient of AUD$70,034 (37,222-110,814) vs AUD$34,325 (16,093 - 69,957), p < 0.001 respectively with an annual excess healthcare cost per PAH patient of AUD$2463 (1973-1885), p < 0.001. The cost of SSc-PAH occurs early post PAH diagnosis with 89.4% utilizing a healthcare service within the first 12 months post PAH diagnosis with an associated cost per patient of AUD$4125 (0-15,666). PAH severity was the main significant determinant of increased healthcare cost (OR 2.5, p = 0.03) in our PAH cohort.
Despite SSc-PAH being a low prevalence disease, it is associated with significant healthcare resource utilization and associated economic burden, predominantly driven by the severity of PAH.
量化肺动脉高压（PAH）在系统性硬化症（SSc）中的经济成本。
通过数据链接来获取医疗保健使用情况，其中澳大利亚硬皮病队列研究中登记的 SSc 患者的临床数据与医院、急诊部（ED）和门诊护理数据库（MBS）链接，时间为 2008-2015 年。PAH 根据国际标准通过右心导管诊断。使用逻辑回归估计医疗保健费用的决定因素。
我们队列在 2008-2015 年期间每位患者的医疗保健总成本（包括医院、ED 和 MBS 费用，但不包括药物费用）中位数（25 至 75 分位）为 37685 澳元（18144-78811），每位患者每年的医疗保健费用为 7506 澳元（5273-10654）。SSc-PAH 患者的总医疗保健费用高于无 PAH 患者，每位患者的总费用分别为 70034 澳元（37222-110814）和 34325 澳元（16093-69957），p<0.001，PAH 患者每年的医疗保健费用超额为 2463 澳元（1973-1885），p<0.001。SSc-PAH 的费用在 PAH 诊断后早期出现，89.4%的患者在 PAH 诊断后 12 个月内使用医疗服务，每位患者的费用为 4125 澳元（0-15666）。PAH 严重程度是我们 PAH 队列中增加医疗保健费用的主要显著决定因素（OR 2.5，p=0.03）。
尽管 SSc-PAH 是一种低患病率疾病，但它与大量医疗资源的利用和相关的经济负担相关，主要由 PAH 的严重程度驱动。
