比较射血分数降低和保留且伴有或不伴有2型糖尿病的心力衰竭住院患者的住院费用。

Comparing inpatient costs of heart failure admissions for patients with reduced and preserved ejection fraction with or without type 2 diabetes.

作者信息

Olchanski Natalia, Vest Amanda R, Cohen Joshua T, DeNofrio David

机构信息

Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies at Tufts Medical Center.

Division of Cardiology, Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts, USA.

出版信息

Cardiovasc Endocrinol Metab. 2020 Feb 21;9(1):17-23. doi: 10.1097/XCE.0000000000000190. eCollection 2020 Mar.

DOI:10.1097/XCE.0000000000000190

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7041871/

Abstract

UNLABELLED

Both heart failure (HF) and diabetes mellitus (DM) account for major healthcare expenditures. We evaluated inpatient expenditures and cost drivers in patients admitted with HF with and without DM.

METHODS

We created a retrospective cohort of acutely decompensated HF patients, using linked data from cost accounting systems and electronic medical records. We stratified patients by LVEF into reduced ejection fraction (HFrEF, LVEF ≤40%) and preserved ejection fraction (HFpEF, LVEF >40%) groups and by DM status at admission.

RESULTS

Our population had 544 people: 285 HFrEF patients (43.5% with DM) and 259 HFpEF patients (43.6% with DM). Patients with HFrEF and DM had the longest hospital stay (5.10 ± 5.21 days). Patients with HFrEF and DM had the highest hospitalization cost ($11 576 ± 15 818). HFrEF and HFpEF patients with DM had the highest cost, and cost per day alive was highest for HFpEF patients with DM [$3153 (95% CI 2332, 4262)].

CONCLUSION

Overall cost was higher for patients with DM, whether or not they were admitted with acute HF due to HFrEF or HFpEF. Cost per day alive for patients with DM continued to exceed corresponding costs for patients without DM, with HFpEF patients with DM having the highest cost.

摘要

未标注

心力衰竭（HF）和糖尿病（DM）均占医疗保健支出的大头。我们评估了合并或不合并DM的HF住院患者的支出及成本驱动因素。

方法

我们利用成本核算系统和电子病历的关联数据，建立了急性失代偿性HF患者的回顾性队列。我们根据左心室射血分数（LVEF）将患者分为射血分数降低（HFrEF，LVEF≤40%）和射血分数保留（HFpEF，LVEF>40%）组，并根据入院时的DM状态进行分层。

结果

我们的研究人群有544人：285例HFrEF患者（43.5%合并DM）和259例HFpEF患者（43.6%合并DM）。HFrEF合并DM的患者住院时间最长（5.10±5.21天）。HFrEF合并DM的患者住院费用最高（11576美元±15818美元）。合并DM的HFrEF和HFpEF患者成本最高，合并DM的HFpEF患者每天的生存成本最高[3153美元（95%CI 2332，4262）]。

结论

无论DM患者因HFrEF还是HFpEF导致急性HF入院，其总体成本都更高。合并DM患者每天的生存成本持续超过未合并DM患者的相应成本，合并DM的HFpEF患者成本最高。