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德国大学医院相关化脓性汗腺炎成本的经济分析。

Economic analysis of the costs associated with Hidradenitis suppurativa at a German University Hospital.

机构信息

Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Bavaria, Germany.

Chair of Health Management, School of Business, Economics and Society, Friedrich-Alexander-University Erlangen-Nürnberg, Nürnberg, Bavaria, Germany.

出版信息

PLoS One. 2021 Aug 4;16(8):e0255560. doi: 10.1371/journal.pone.0255560. eCollection 2021.

Abstract

BACKGROUND AND OBJECTIVES

Hidradenitis suppurativa (HS) significantly affects the patient`s quality of life and leads to multiple medical consultations. Aim of this study was to assess the utilization of medical care of HS patients.

PATIENTS AND METHODS

All patients presenting in 2017 for an outpatient, day patient and / or inpatient treatment with leading claim type HS at the Department of Dermatology, University Hospital Würzburg, were included. Primary outcome was the economic burden of HS patients, measured by resource utilization in €.

RESULTS

The largest share of the direct medical costs for HS were the inpatient costs with a leading surgical diagnosis-related group (DRG). Antiseptics were the predominant topical prescription. While doxycycline was the most frequently prescribed systemic therapy, adalimumab was the main cost driver. The difference between in-patient (€ 110.25) and outpatient (€ 26.34) direct non-medical costs was statistically significant (p < 0.001). With regards to indirect medical costs, a statistically significantly higher loss of gross value added (inpatient mean € 1,827.00; outpatient mean € 203.00) and loss of production (inpatient mean € 1,026.00; outpatient mean € 228.00) could be noted (p < 0.001), respectively.

CONCLUSIONS

The present study on disease-specific costs of HS confirms that the hospital care of patients with this disease is cost-intensive. However, the primary goal of physicians is not and should not be to save costs regarding their patients`treatment, but rather the premise to utilize the existing resources as efficient as possible. Reducing the use of costly therapeutics and inpatient stays therefore requires more effective therapy options with an improved cost-benefit profile.

摘要

背景与目的

化脓性汗腺炎(HS)显著影响患者的生活质量并导致多次就诊。本研究旨在评估 HS 患者的医疗保健利用情况。

患者与方法

2017 年,所有因门诊、日间住院和/或住院治疗,且主要诊断类型为 HS 的患者在维尔茨堡大学医院皮肤科就诊。主要结局是评估 HS 患者的经济负担,以欧元为单位衡量资源利用情况。

结果

HS 的直接医疗费用中,住院费用占比最大,主要手术诊断相关组(DRG)。防腐剂是主要的局部处方。虽然多西环素是最常用的系统治疗药物,但阿达木单抗是主要的成本驱动因素。住院(€110.25)和门诊(€26.34)直接非医疗费用之间存在统计学差异(p<0.001)。在间接医疗成本方面,住院患者的毛附加值损失(平均€1827.00)和生产损失(平均€1026.00)均显著高于门诊患者(分别为 p<0.001)。

结论

本研究对 HS 的特定疾病成本进行了分析,证实了对该疾病患者的住院治疗成本高昂。然而,医生的首要目标不应该是在治疗患者时节省成本,而是要充分利用现有的资源。为了减少昂贵治疗方法和住院治疗的使用,因此需要更有效的治疗方法,以改善成本效益。

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本文引用的文献

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Disease Trajectories for Hidradenitis Suppurativa in the Danish Population.
JAMA Dermatol. 2020 Jul 1;156(7):780-786. doi: 10.1001/jamadermatol.2020.1281.
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Systematic Review of Complications and Recurrences After Surgical Interventions in Hidradenitis Suppurativa.
Dermatol Surg. 2020 Jul;46(7):914-921. doi: 10.1097/DSS.0000000000002323.
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What is hidradenitis suppurativa?
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