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肾移植受者良性和恶性皮肤病变的临床和经济负担。

Clinical and economic burden of benign and malignant skin lesions in renal transplant recipients.

机构信息

School of Medicine and Dentistry, Griffith University, Brisbane, Queensland, Australia.

Department of Nephrology, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia.

出版信息

Intern Med J. 2023 Nov;53(11):2042-2049. doi: 10.1111/imj.16024. Epub 2023 Feb 13.

Abstract

BACKGROUND

Studies evaluating the economic burden of dermatological care in the transplant setting are currently not available in Australia.

AIMS

To evaluate the clinical and economic burden of benign and malignant skin lesions in renal transplant recipients in Central Queensland.

METHODS

A bottom-up approach was used to determine the clinical burden and direct costs from patient-level Medicare data obtained from Service Australia for skin lesions.

RESULTS

Seventy-six percent of the renal transplant population in Central Queensland participated in this study. The median age was 57.0 years (standard deviation ± 13.6) and the majority (61.8%) of participants were men. The mean duration after transplant surgery was 99.9 months (interquartile range, 73.2-126.6 months). During a 2-year follow-up, 22 (40%) patients were diagnosed with benign skin lesions, 21 (38%) with nonmelanoma skin carcinoma (NMSC) and one (2%) with melanoma. There was a total of 231 visits to clinicians for diagnostic and therapeutic skin procedures and the direct costs to Medicare was $48 806 Australian Dollars (AUD) or $30 427 US Dollars (USD). Approximately 86% of the total direct costs was spent for nonNMSC and mean direct costs for NMSC was $763 AUD (or $476 USD).

CONCLUSION

This Medicare data-based study provides further insight into the burgeoning clinical and economic burden of the care for benign and malignant skin lesions in the renal transplantation setting in Australia.

摘要

背景

目前在澳大利亚,尚无评估皮肤科治疗在移植环境下的经济负担的研究。

目的

评估昆士兰中部地区肾移植受者良性和恶性皮肤病变的临床和经济负担。

方法

采用自下而上的方法,从澳大利亚服务局获得的医疗保险皮肤病变患者数据中确定皮肤病变的临床负担和直接成本。

结果

昆士兰中部地区 76%的肾移植人群参与了这项研究。中位年龄为 57.0 岁(标准差±13.6),大多数(61.8%)参与者为男性。移植手术后的平均时间为 99.9 个月(四分位距,73.2-126.6 个月)。在 2 年的随访期间,22 名(40%)患者被诊断为良性皮肤病变,21 名(38%)患者患有非黑素瘤皮肤癌(NMSC),1 名(2%)患者患有黑色素瘤。共有 231 次就诊于临床医生进行诊断和治疗皮肤疾病,医疗保险的直接费用为 48806 澳元(或 30427 美元)。总直接费用的约 86%用于非 NMSC,NMSC 的平均直接费用为 763 澳元(或 476 美元)。

结论

这项基于医疗保险数据的研究进一步深入了解了澳大利亚肾移植环境中良性和恶性皮肤病变治疗的日益增加的临床和经济负担。

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