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2019 年哥伦比亚安蒂奥基亚一家医院肝移植患者早期血管和胆道并发症相关成本:病例系列。

Costs Associated With Early Vascular and Biliary Complications in Liver-Transplanted Patients in a Hospital in Antioquia, Colombia 2019: A Case Series.

机构信息

San Vicente Foundation Hospital, Medellín and Rionegro, CES University, Medellin, Colombia.

San Vicente Foundation Hospital, Rionegro, Colombia.

出版信息

Value Health Reg Issues. 2020 Dec;23:131-136. doi: 10.1016/j.vhri.2020.06.004. Epub 2020 Nov 19.

DOI:10.1016/j.vhri.2020.06.004
PMID:33221679
Abstract

OBJECTIVES

Vascular and biliary complications associated with liver transplants involve high morbidity and mortality as well as cost overrun for health systems. Efforts to prioritize their prevention require not only clinical information but also information on costs that reflect the economic burden on health systems. The objective of this study was to describe cost overrun incurred from early vascular and biliary complications after liver transplant.

METHODS

This cases series included liver transplant patients treated at the San Vicente Foundation University Hospital, Rionegro, Antioquia, from January 1, 2013, to December 31, 2018. All liver transplant patients treated during the above period were included; the absence of clinical records on the variables of interest was considered the exclusion criterion. A probabilistic analysis of patient cost was performed. Monte Carlo simulations as well as a 1-way sensitivity analysis per transplant cost component were performed.

RESULTS

Records from 154 patients were assessed. The average patient age was 56.9 (SD 10.9) years; 42.9% of patients were women. Of all, 36.4% patients were classified as Child C, and the average Model for End-Stage Liver Disease score was 19.6. The average cost for patients without complications was $27 834.82, whereas that for patients with early vascular complications was $36 747.83 and for those with early biliary complications was $38 523.74.

CONCLUSION

Early vascular and biliary complications after liver transplant increase healthcare costs, with the increase being significant in patients with biliary complications.

摘要

目的

与肝移植相关的血管和胆道并发症具有较高的发病率和死亡率,并且会导致医疗系统成本超支。优先预防这些并发症不仅需要临床信息,还需要反映医疗系统经济负担的成本信息。本研究的目的是描述肝移植后早期血管和胆道并发症导致的成本超支。

方法

本病例系列研究纳入了 2013 年 1 月 1 日至 2018 年 12 月 31 日期间在圣维森特基金会大学医院(安蒂奥基亚州里翁格雷罗)接受治疗的肝移植患者。所有在此期间接受治疗的肝移植患者均被纳入研究;如果患者的临床记录中缺乏我们感兴趣的变量,则被视为排除标准。对患者成本进行概率分析,并进行蒙特卡罗模拟以及每次移植成本组成部分的单因素敏感性分析。

结果

共评估了 154 例患者的记录。患者的平均年龄为 56.9(SD 10.9)岁,42.9%的患者为女性。其中,36.4%的患者为 Child C 级,平均终末期肝病模型评分 19.6。无并发症患者的平均费用为 27834.82 美元,而早期血管并发症患者的费用为 36747.83 美元,早期胆道并发症患者的费用为 38523.74 美元。

结论

肝移植后早期血管和胆道并发症会增加医疗保健成本,胆道并发症患者的成本增加更为显著。

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