Department of Medicine, University of Washington, Seattle, WA, USA.
Health Sciences Library, University of Washington, Seattle, WA, USA.
Int J Cardiol. 2021 Jan 15;323:235-241. doi: 10.1016/j.ijcard.2020.09.020. Epub 2020 Sep 10.
Rheumatic heart disease (RHD) remains endemic in less-resourced regions and countries and results in high medical and non-medical costs to households, health systems, and society. This scoping review maps out the available evidence on the economic impact of RHD and its antecedents and suggests future research priorities.
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. We identified articles through systematic electronic database search supplemented by expert knowledge of unpublished literature. Studies were included if they collected empirical RHD-related costing data as a primary or secondary objective and if the data were collected from 2000 onward. Main quantitative findings by intervention, costing perspective, and location were charted, and a standardized quality assessment tool was used to appraise included studies.
The index search identified 2519 electronic records and two grey-literature graduate theses. Six full texts were included in the review. Primary prevention costs were modest, while secondary and especially tertiary prevention were more costly. Most estimates were of health sector costs and for tertiary interventions. Only two studies described RHD-related costs in non-high-income countries. Most studies were of adequate methodological quality.
Research into the costs of RHD has mostly been done in wealthy countries. Costs from the household perspective, which are particularly important in countries with limited public healthcare finance, are lacking. To inform advocacy and guide implementation of the 2018 World Health Assembly resolution on RHD, high-quality, local cost estimates will be needed from a range of representative, RHD-endemic countries.
风湿性心脏病（RHD）在资源较少的地区和国家仍然流行，给家庭、卫生系统和社会带来了高昂的医疗和非医疗成本。本范围综述旨在梳理 RHD 及其前身的经济影响的现有证据，并提出未来的研究重点。
我们遵循了系统评价和荟萃分析扩展的首选报告项目，通过系统的电子数据库搜索，并辅以对未发表文献的专家知识，来确定文章。如果研究作为主要或次要目标收集了与 RHD 相关的成本数据，并且数据是在 2000 年以后收集的，则将其纳入研究。按干预措施、成本视角和地点绘制了主要的定量发现，并使用标准化的质量评估工具对纳入的研究进行评估。
索引搜索确定了 2519 条电子记录和两份灰色文献研究生论文。有 6 篇全文纳入了综述。初级预防的成本较低，而二级和特别是三级预防的成本较高。大多数估计是卫生部门的成本和三级干预的成本。只有两项研究描述了非高收入国家的 RHD 相关成本。大多数研究的方法质量都很高。
RHD 成本的研究主要在富裕国家进行。缺乏来自家庭视角的成本，而家庭视角在公共医疗保健资金有限的国家尤其重要。为了支持宣传并指导 2018 年世界卫生大会关于 RHD 的决议的实施，需要来自一系列具有代表性的 RHD 流行国家的高质量、本土化的成本估计。
