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哮喘相关死亡前的医疗资源消耗:一项全国性描述性研究。

Healthcare resource consumption prior to asthma-related death: a nationwide descriptive study.

机构信息

Pôle des Voies Respiratoires, Service de Pneumo-allergologie, Centre Hospitalo-Universitaire de Toulouse, 24 chemin de Pouvourville, 31059 Toulouse, France.

Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Inserm U1291, CNRS U5282, University of Toulouse, Toulouse, France.

出版信息

Ther Adv Respir Dis. 2022 Jan-Dec;16:17534666221130217. doi: 10.1177/17534666221130217.

Abstract

BACKGROUND

Although asthma mortality declined sharply until the mid-2000s, a stagnation in mortality has been observed over the past decade in different countries.

OBJECTIVE

The objective of this study is to describe healthcare resource consumption for patients who died from asthma in France.

METHOD

This study was conducted using data from the French National Health Data System. Patients who died from asthma between 2013 and 2017 were identified by the ICD10 codes J45 and J46. Health care consumption data were collected. Patients were categorized into four categories according to age: ⩾75, (18-75), (12-18), (0-12). Daily doses of ICS were categorized according to GINA guidelines.

RESULTS

A total of 3829 patients were included. No ICS or an inadequate ICS dose was observed in 43.8%, 50.6%, 48.1%, and 54.0% of patients aged ⩾75, (18-74), (12-18), and (0-12) years, respectively. Dispensation of six or more SABA canisters was observed in 37.2%, 49.0%, and 70.3% of patients aged of ⩾75, (18-75), and (12-18) years, respectively. Omalizumab dispensation rate was very low [1.1% and 2.8% in patients aged ⩾75 and (18-75) years)]. The proportion of patients with a pulmonologist office visit was 13.8% and 14.6% in patients ⩾75 and (18-75) years, respectively. A lung function test was noted in only 18.6%, 28.3%, and 25.9% of patients ⩾75, (18-75) and (12-18) years, respectively.

CONCLUSION

Half of the patients who died from asthma received inadequate ICS doses and only a small proportion had access to biological therapies. Less than 15% were referred to a specialist.

摘要

背景

尽管哮喘死亡率在 21 世纪中期之前急剧下降,但在过去十年中,不同国家的死亡率已趋于稳定。

目的

本研究旨在描述法国因哮喘死亡患者的医疗资源消耗情况。

方法

本研究使用了法国国家卫生数据系统的数据。通过 ICD10 编码 J45 和 J46 确定了 2013 年至 2017 年期间因哮喘死亡的患者。收集了医疗保健消耗数据。根据年龄将患者分为四组:≥75 岁、(18-75)岁、(12-18)岁、(0-12)岁。根据 GINA 指南对 ICS 的日剂量进行分类。

结果

共纳入 3829 名患者。≥75 岁、(18-74)岁、(12-18)岁和(0-12)岁的患者中,分别有 43.8%、50.6%、48.1%和 54.0%未使用 ICS 或 ICS 剂量不足。≥75 岁、(18-75)岁和(12-18)岁的患者中,分别有 37.2%、49.0%和 70.3%使用了 6 个或更多沙丁胺醇气雾剂罐。奥马珠单抗的使用率非常低[≥75 岁和(18-75)岁的患者中分别为 1.1%和 2.8%]。≥75 岁和(18-75)岁的患者中,有肺科医生就诊的比例分别为 13.8%和 14.6%。仅 18.6%、28.3%和 25.9%的≥75 岁、(18-75)岁和(12-18)岁的患者进行了肺功能检查。

结论

一半因哮喘死亡的患者接受的 ICS 剂量不足,只有一小部分患者能够获得生物治疗。不到 15%的患者被转介给专家。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4818/9577087/6f566f8c5c30/10.1177_17534666221130217-fig1.jpg

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