Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
Department of Paediatric Haematology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Pediatr Blood Cancer. 2020 Sep;67(9):e28588. doi: 10.1002/pbc.28588. Epub 2020 Jul 16.
While multiple studies have examined the cost of health care for one aspect of sickle cell disease care, few have focussed on the overall cost of comprehensive care for sickle cell disease.
We conducted a retrospective cohort study of children with sickle cell disease treated in a comprehensive care centre from 1 January 2015 to 31 December 2016. Health care utilisation of included patients was based upon data from two main sources. The clinical practice guideline was used to determine the expected resource use of routine comprehensive care (planned elective care), and the financial claims database was used to estimate real-world resource use associated with acute and inpatient care (additional care).
A total of 125 children with sickle cell disease were analysed. Expenditures for these patients averaged €5049 [standard deviation (SD) €1634] per child per year. Total yearly costs per patient varied considerably, ranging from €669 to €84 010, and less than 15% of patients were responsible for 50% of the health care costs. The majority (37%) of costs was associated with inpatient hospital care, which increased by age group, 27% with diagnostics, 19% with treatment, 11% with outpatients' visits and 6% with emergency care.
We have described real-world resource use and expenditures for children with sickle cell disease in a European comprehensive care centre. It seems that costs of a comprehensive approach with effective management in the outpatient setting is favourable when compared to episodic health care.
尽管多项研究已经考察了镰状细胞病护理某一方面的医疗保健费用,但很少有研究关注镰状细胞病综合护理的总体成本。
我们对 2015 年 1 月 1 日至 2016 年 12 月 31 日在一个综合护理中心接受治疗的镰状细胞病儿童进行了回顾性队列研究。纳入患者的医疗保健利用情况基于两个主要来源的数据。临床实践指南用于确定常规综合护理(计划选择性护理)的预期资源使用情况,而财务索赔数据库用于估计与急性和住院护理相关的实际资源使用情况(额外护理)。
共分析了 125 名镰状细胞病患儿。这些患者的平均支出为每个孩子每年 5049 欧元(标准差 1634 欧元)。每位患者的年总费用差异很大,范围从 669 欧元到 84010 欧元,不到 15%的患者承担了 50%的医疗保健费用。大部分(37%)费用与住院医院护理有关,按年龄组划分,诊断费用增加了 27%,治疗费用增加了 19%,门诊就诊费用增加了 11%,急诊费用增加了 6%。
我们描述了欧洲综合护理中心中镰状细胞病儿童的实际资源利用和支出情况。与 episodic health care 相比,在门诊环境中采用综合方法进行有效管理的成本似乎更为有利。