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轴向型脊柱关节炎患者是医疗资源的大量消耗者,尤其是年轻患者和女性患者:西班牙地图集研究结果

Patients with Axial Spondyloarthritis are Great Consumers of Healthcare Resources, Especially Young and Women: Results from the Spanish Atlas.

作者信息

Garrido-Cumbrera Marco, Collantes-Estévez Eduardo, Navarro-Compán Victoria, Zarco-Montejo Pedro, Sastre Carlos, Correa-Fernández José, Gratacós Jordi

机构信息

Health & Territory Research (HTR), Universidad de Sevilla, Seville, Spain.

Spanish Federation of Spondyloarthritis Associations (CEADE), Madrid, Spain.

出版信息

Rheumatol Ther. 2023 Jun;10(3):729-739. doi: 10.1007/s40744-023-00543-3. Epub 2023 Mar 6.

Abstract

INTRODUCTION

This study aimed to assess high healthcare utilization over 1 year in patients with axial spondyloarthritis (axSpA) and factors associated with increased healthcare utilization.

METHODS

A total of 530 unselected patients with axSpA from the Atlas of Axial Spondyloarthritis in Spain-who had used at least one healthcare resource-were included in the present study. Total health care utilization was obtained from the total number of healthcare visits, medical tests, hospital admissions and emergency visits, during the 12 months prior to the survey. Linear regression was used to analyse possible factors associated with higher healthcare utilization.

RESULTS

A total of 530 patients with axSpA participated in this study: mean age was 45.3 years and 51.1% were female. In the previous 12 months, 77.9% (n = 530) used at least one healthcare resource, with the median healthcare utilization at 25. In the multiple linear regression, the only categorical factor associated with higher healthcare utilization was female gender (β = 12.854), while the continuous factors associated with higher healthcare utilization were higher disease activity (β = 3.378), longer diagnostic delay (β = 0.959), younger age (β = - 0.737) and greater functional limitation (β = 0.576).

CONCLUSION

Half of patients with axSpA used 25 or more healthcare resources during 1 year. Higher healthcare utilization was associated with younger age, female gender, greater disease activity, higher functional limitation and longer diagnostic delay. Optimal monitoring of patients with axSpA may help to reduce their healthcare utilization.

摘要

引言

本研究旨在评估轴性脊柱关节炎(axSpA)患者1年内的高医疗利用率以及与医疗利用率增加相关的因素。

方法

本研究纳入了来自西班牙轴性脊柱关节炎图谱的530例未经挑选的axSpA患者,这些患者至少使用过一种医疗资源。总医疗利用率通过调查前12个月内的医疗就诊、医学检查、住院和急诊就诊总数得出。采用线性回归分析与较高医疗利用率相关的可能因素。

结果

共有530例axSpA患者参与了本研究:平均年龄为45.3岁,女性占51.1%。在过去12个月中,77.9%(n = 530)的患者至少使用过一种医疗资源,医疗利用率中位数为25。在多元线性回归中,与较高医疗利用率相关的唯一分类因素是女性性别(β = 12.854),而与较高医疗利用率相关的连续因素是较高的疾病活动度(β = 3.378)、较长的诊断延迟(β = 0.959)、较年轻的年龄(β = -0.737)和较大的功能受限(β = 0.576)。

结论

一半的axSpA患者在1年内使用了25种或更多的医疗资源。较高的医疗利用率与较年轻的年龄、女性性别、较高的疾病活动度、较高的功能受限和较长的诊断延迟相关。对axSpA患者进行最佳监测可能有助于降低其医疗利用率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60f6/10140249/6c31fcda8b84/40744_2023_543_Fig1_HTML.jpg

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