恰加斯病和非恰加斯病匹配队列中心力衰竭患者1年医疗资源利用及相关成本的比较。
Comparison of 1-year healthcare resource utilization and related costs for patients with heart failure in the Chagas and non-Chagas matched cohorts.
作者信息
Olivera Mario J, Arévalo Adriana, Muñoz Lyda, Duque Sofía, Bedoya Juan, Parra-Henao Gabriel
机构信息
Grupo de Parasitología, Instituto Nacional de Salud, Calle 26 CAN #51-20, Bogotá, DC 111321,Colombia.
Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, DC, Colombia.
出版信息
Ther Adv Infect Dis. 2022 Jul 23;9:20499361221114270. doi: 10.1177/20499361221114270. eCollection 2022 Jan-Dec.
BACKGROUND
Chagas disease is one of the leading causes of heart failure (HF) in Latin Americans, and there are limited data available that examine related costs of care for patients with HF. This study aimed to compare healthcare resource utilization and related costs for patients with HF, with and without Chagas disease.
METHODS
A prospective matched-cohort study comparing the healthcare costs for patients with HF with Chagas disease and care costs for patients with HF without Chagas disease was conducted between January 2019 and December 2019. Only direct costs have been estimated, including hospitalization costs, medications and other cardiovascular interventions, and clinical and laboratory follow-up for up to 1 year.
RESULTS
A total of 80 patients with chronic HF were included in the study. Of the 80 patients, 40 patients in the Chagas cohort and 40 patients in the non-Chagas cohort were matched for age, insurer and sex. From a social security system perspective, the total costs for the two cohorts during the study period were U$970,136. Specifically, the healthcare costs for the Chagas cohort were greater than the total healthcare costs for the non-Chagas group (U$511,931 U$458,205; = 0.6183) Most costs were associated with hospitalizations (65.5% 59.6%), with averages of U$12,798.5 and U$11,455.1 per person in the Chagas and non-Chagas groups, respectively. In both the Chagas (51.6%) and non-Chagas cohorts (54.5%), causes of readmission unrelated to HF outweighed causes of readmission related to HF. High incidences of hospital admissions were observed during the rainy (cold) season for both cohorts.
CONCLUSIONS
Over a 12-month follow-up period, patients with chronic HF and Chagas consume as many healthcare resources as those with chronic HF and without Chagas. These data highlight the considerable and growing economic burden of HF on the Colombian health system.
背景
恰加斯病是拉丁美洲人心力衰竭（HF）的主要病因之一，而关于HF患者相关护理费用的可用数据有限。本研究旨在比较患有和未患有恰加斯病的HF患者的医疗资源利用情况及相关费用。
方法
2019年1月至2019年12月期间，进行了一项前瞻性匹配队列研究，比较了恰加斯病HF患者的医疗费用和非恰加斯病HF患者的护理费用。仅估算了直接成本，包括住院费用、药物及其他心血管干预措施，以及长达1年的临床和实验室随访费用。
结果
本研究共纳入80例慢性HF患者。在这80例患者中，恰加斯队列的40例患者和非恰加斯队列的40例患者在年龄、保险商和性别方面进行了匹配。从社会保障系统的角度来看，研究期间两个队列的总费用为970,136美元。具体而言，恰加斯队列的医疗费用高于非恰加斯组的总医疗费用（511,931美元对458,205美元；P = 0.6183）。大部分费用与住院相关（65.5%对59.6%），恰加斯组和非恰加斯组人均住院费用分别为12,798.5美元和11,455.1美元。在恰加斯队列（51.6%）和非恰加斯队列（54.5%）中，与HF无关的再入院原因均超过了与HF相关的再入院原因。两个队列在雨季（寒冷季节）的住院率均较高。
结论
在12个月的随访期内，慢性HF合并恰加斯病的患者与慢性HF未合并恰加斯病的患者消耗的医疗资源一样多。这些数据凸显了HF给哥伦比亚卫生系统带来的巨大且不断增加的经济负担。
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