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香港罕见神经系统疾病的患病率和医疗保健利用情况:2014-2018 年。

Prevalence and healthcare utilization of rare neurological diseases in Hong Kong: 2014-2018.

机构信息

Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China.

Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

Eur J Neurol. 2021 Jul;28(7):2305-2312. doi: 10.1111/ene.14852. Epub 2021 Apr 20.

Abstract

BACKGROUND

There has been increasing attention focused on the epidemiology of rare diseases (RDs) in recent years. Rare neurological diseases (RNDs) constitute a significant proportion of RDs; however, relevant research is still lacking.

METHODS

A list of ICD-10 codes corresponding to RNDs was compiled using adaptations from the Orphanet Classification of Rare Diseases, and classified into rare epilepsy, movement-related, neurocutaneous, neuroimmune, neurometabolic and neurodegenerative, neuromuscular and other RNDs. Using the Clinical Data Analysis and Reporting System, which holds public hospital healthcare records of Hong Kong anonymously, we calculated the prevalence and healthcare utilization of RND patients between 2014 and 2018. The list of RNDs was also used to review relevant pharmacological trials within the International Clinical Trials Registry Platform between 2009 and 2018.

RESULTS

The prevalence of RNDs in Hong Kong is 3.6 in 1,000 individuals. Patients with RNDs had frequent emergency department, outpatient and inpatient healthcare utilization. The average annual cost per patient is estimated at HKD 182,075 (€ 19,688). Different categories of RNDs showed different patterns of healthcare utilization. Moreover, there were only 677 RND-related pharmacological trials during the study period, and no trial was found for 78% of RNDs.

CONCLUSIONS

This is one of the first population studies on the prevalence and healthcare utilization patterns of RNDs, with comprehensive reviews of RND-related pharmacological research. It shows high healthcare utilization rates among patients with RNDs, as well as a wide research gap in many RNDs. We call for better attention and tailored healthcare for these patients.

摘要

背景

近年来,人们越来越关注罕见病(RDs)的流行病学。罕见神经系统疾病(RNDs)是 RDs 的重要组成部分,但相关研究仍较为缺乏。

方法

我们参考 Orphanet 罕见病分类法,改编后制定了一份 RNDs 的 ICD-10 编码列表,并将其分为罕见癫痫、运动障碍、神经皮肤疾病、神经免疫、神经代谢和神经退行性疾病、神经肌肉疾病和其他 RNDs。利用临床数据分析和报告系统(该系统匿名保存香港公立医院的医疗记录),我们计算了 2014 年至 2018 年 RND 患者的患病率和医疗保健利用率。我们还利用该列表审查了 2009 年至 2018 年国际临床试验注册平台中与 RND 相关的药理学试验。

结果

香港 RNDs 的患病率为每 1000 人中有 3.6 人。RND 患者经常到急诊室、门诊和住院部就诊。每位患者的年均医疗费用估计为 182075 港元(19688 欧元)。不同类别的 RNDs 显示出不同的医疗保健利用模式。此外,研究期间仅开展了 677 项 RND 相关的药理学试验,有 78%的 RND 没有相关试验。

结论

这是第一项针对 RND 患病率和医疗保健利用模式的人群研究之一,对 RND 相关药理学研究进行了全面综述。结果表明,RND 患者的医疗保健利用率较高,许多 RNDs 的研究存在较大空白。我们呼吁为这些患者提供更好的关注和针对性的医疗保健。

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