2006 年至 2019 年家用呼吸设备的增长情况及卫生政策的成本控制。
Growth of home respiratory equipment from 2006 to 2019 and cost control by health policies.
机构信息
Service de soins de suite et réhabilitation respiratoire (Département "R3S"), Groupe Hospitalier Pitié-Salpêtrière-Charles-Foix, AP-HP, 47-83 boulevard de l'Hôpital, 75013 Paris, France; Département de pneumologie, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France; Respiratory Support, Chronic Care Group (GAVO2) of the French respiratory Society of Respiratory Disease (SPLF), France.
Département de Santé Publique, Groupe Hospitalier Pitié-Salpêtrière-Charles-Foix, AP-HP, 47-83 boulevard de l'Hôpital, 75013 Paris, France; INSERM, UMRS 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique, équipe 6, Sorbonne Université, UPMC Université Paris 06, 47-83 boulevard de l'Hôpital, 75061 Paris Cedex 13, France.
出版信息
Respir Med Res. 2022 Nov;82:100930. doi: 10.1016/j.resmer.2022.100930. Epub 2022 Jun 11.
BACKGROUND
Home respiratory equipment (HRE) designed for the management of chronic respiratory failure includes oxygen therapy (O), noninvasive ventilation (NIV) and mechanical insufflation-exsufflation (MI-E). The growth of the number of patients treated by HRE, the prevalence and the associated costs in France have not been determined.
METHODS
The French open access national health insurance aggregated data was used to estimate the evolution of theses parameters from 2006 to 2019.
RESULTS
The number of patients treated by HRE increased by 117% between 2006 and 2019, reaching a total of 245,896 patients (367/100,000). Prescriptions for O, NIV, and MI-E increased by 88%, 189% and 162%, respectively. In 2019, 139,323 patients received long-term home O alone (208/100,000) with a 13% decrease for liquid O compared to a 44% increase for O concentrator. The number of patients treated by portable oxygen concentrator increased by 509% over the last 5 years. In 2019, 96,126 patients received NIV (144/100,000) and 97% of these patients were treated by NIV for less than 12 h/day. A total of 9,158 patients were treated by MI-E in 2019 (13.6/100,000). Despite the global increase in the number of patients, health costs decreased from 9% to 8% of total medical device spending in 2019 due to adjustment of health policies, such as a reduction of reimbursement rates.
CONCLUSION
Our results highlighted the high rate of HRE prescription, but with cost control as a result of adapted health policies.
背景
用于管理慢性呼吸衰竭的家庭呼吸设备（HRE）包括氧疗（O）、无创通气（NIV）和机械通气-呼气（MI-E）。法国尚未确定接受 HRE 治疗的患者人数、患病率和相关费用的增长情况。
方法
使用法国开放获取的全民健康保险汇总数据来估计这些参数从 2006 年到 2019 年的演变情况。
结果
2006 年至 2019 年间，接受 HRE 治疗的患者人数增加了 117%，达到 245896 人（每 10 万人中有 367 人）。O、NIV 和 MI-E 的处方量分别增加了 88%、189%和 162%。2019 年，有 139323 名患者单独接受长期家庭 O 治疗（每 10 万人中有 208 人），与液体 O 相比，O 浓缩器增加了 44%，而液体 O 减少了 13%。便携式氧气浓缩器的患者人数在过去 5 年中增加了 509%。2019 年，有 96126 名患者接受 NIV（每 10 万人中有 144 人），其中 97%的患者每天接受 NIV 治疗时间少于 12 小时。2019 年共有 9158 名患者接受 MI-E 治疗（每 10 万人中有 13.6 人）。尽管患者人数总体增加，但由于医疗政策的调整，如降低报销率，医疗设备总支出中的健康成本从 9%下降到 2019 年的 8%。
结论
我们的研究结果强调了 HRE 处方的高比率，但由于适应医疗政策，成本得到了控制。
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