TRAGSA Group, Madrid, Spain.
Emergencies Coordination Centre, Madrid Region Emergency Medical Service (SUMMA 112), Madrid, Spain.
J Viral Hepat. 2021 Jun;28(6):859-869. doi: 10.1111/jvh.13491. Epub 2021 Mar 8.
This work evaluates the potential impact at territorial level of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System on hepatitis C virus (HCV)-associated hospitalizations. Chronic HCV-related hospitalization discharges from 2014 to 2018 were obtained from the National Registry of Hospitalisations. A descriptive analysis of the hospitalizations was performed for all chronic, advanced liver disease and non-advanced liver disease. Hospitalization rates were calculated at national and regional level. Year 2015 and period 2016-2018 hospitalization rates were compared to 2014 hospitalization rates using a Poisson model. Municipal standardized hospitalization rates ratios adjusted by age-group were calculated for 2016-2018 period (2014 hospitalization rates as reference). From 2014 to 2018, there were 22,352 chronic HCV-related hospitalizations. In-hospital fatality rate was 4.3% for non-advanced liver disease and 11.7% for advanced liver disease patients. National hospitalization rate decreased 22% (95% CI: 21%-22%), 16% (95% CI: 15%-17%) and 34% (95% CI: 33%-35%) in 2016-2018 compared to 2014 for all chronic, non-advanced and advanced liver disease, respectively. During 2016-2018 period, 11/19 Spanish regions achieved >20% decrease in the hospitalization rates (p < .001) for non-advanced liver disease and 19/19 (except Melilla, the rest with p < .001) for advanced liver disease. At municipal level, 84.8% and 90.2% municipalities had <20% of chronic HCV-related hospitalization need compared to 2014 adjusted by age-group. Based on the data analysed, a high impact on reducing chronic HCV-associated hospitalizations have been achieved after the implementation of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System. However, small differences between regions and rural/urban areas were noticed.
本研究评估了西班牙国家卫生系统《解决丙型肝炎战略计划》在地域层面上对丙型肝炎病毒（HCV）相关住院治疗的潜在影响。从国家住院登记处获取了 2014 年至 2018 年慢性 HCV 相关住院治疗的出院数据。对所有慢性、晚期和非晚期肝病患者的住院情况进行了描述性分析。在国家和地区层面计算了住院率。使用泊松模型比较了 2015 年和 2016-2018 年期间的住院率与 2014 年住院率。2016-2018 年期间，以 2014 年住院率为参照，计算了经年龄组调整的市级标准化住院率比值。2014 年至 2018 年，共发生 22352 例慢性 HCV 相关住院治疗。非晚期肝病患者的院内病死率为 4.3%，晚期肝病患者的病死率为 11.7%。2016-2018 年，与 2014 年相比，所有慢性、非晚期和晚期肝病患者的全国住院率分别下降了 22%（95%CI：21%-22%）、16%（95%CI：15%-17%）和 34%（95%CI：33%-35%）。在 2016-2018 年期间，除梅利利亚外，西班牙 19 个地区中 18 个地区（p<0.001）的非晚期肝病患者住院率降幅均超过 20%，除梅利利亚外，西班牙 19 个地区（p<0.001）的晚期肝病患者住院率降幅均超过 20%。在市级层面，84.8%和 90.2%的市级地区的慢性 HCV 相关住院治疗需求较 2014 年经年龄组调整后减少了 20%。基于分析数据，在西班牙国家卫生系统实施《解决丙型肝炎战略计划》后，慢性 HCV 相关住院治疗的减少取得了显著效果。然而，地区之间和城乡之间仍存在一定差异。
