Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands.
Department of Cardiology, CARIM, Maastricht University Medical Centre, 6229 ER Maastricht, The Netherlands.
Eur Heart J Qual Care Clin Outcomes. 2024 Jun 20;10(4):334-344. doi: 10.1093/ehjqcco/qcad056.
Dilated cardiomyopathy (DCM) is a major cause of heart failure impairing patient wellbeing and imposing a substantial economic burden on society, but respective data are missing. This study aims to measure the quality of life (QoL) and societal costs of DCM patients.
A cross-sectional evaluation of QoL and societal costs of DCM patients was performed through the 5-level EuroQol and the Medical Consumption Questionnaire and Productivity Cost Questionnaire, respectively. QoL was translated into numerical values (i.e. utilities). Costs were measured from a Dutch societal perspective. Final costs were extrapolated to 1 year, reported in 2022 Euros, and compared between DCM severity according to NYHA classes. A total of 550 DCM patients from the Maastricht cardiomyopathy registry were included. Mean age was 61 years, and 34% were women. Overall utility was slightly lower for DCM patients than the population mean (0.840 vs. 0.869, P = 0.225). Among EQ-5D dimensions, DCM patients scored lowest in 'usual activities'. Total societal DCM costs were €14 843 per patient per year. Cost drivers were productivity losses (€7037) and medical costs (€4621). Patients with more symptomatic DCM (i.e. NYHA class III or IV) had significantly higher average DCM costs per year compared to less symptomatic DCM (€31 099 vs. €11 446, P < 0.001) and significantly lower utilities (0.631 vs. 0.883, P < 0.001).
DCM is associated with high societal costs and reduced QoL, in particular with high DCM severity.
扩张型心肌病（DCM）是心力衰竭的主要病因，降低患者的生活质量并给社会带来沉重的经济负担，但目前缺乏相关数据。本研究旨在评估 DCM 患者的生活质量（QoL）和社会成本。
通过 5 级欧洲五维健康量表（EQ-5D）和医疗消费问卷（MCQ）及生产力成本问卷（PCQ）分别评估 DCM 患者的 QoL 和社会成本。QoL 被转化为数值（即效用值）。成本从荷兰社会角度进行测量。最终成本外推至 1 年，按 2022 年欧元计算，并根据 NYHA 心功能分级比较 DCM 严重程度之间的差异。共纳入来自马斯特里赫特心肌病注册研究的 550 例 DCM 患者。患者平均年龄为 61 岁，34%为女性。DCM 患者的总体效用值略低于普通人群（0.840 比 0.869，P=0.225）。在 EQ-5D 维度中，DCM 患者在“日常活动”方面的评分最低。总社会 DCM 成本为每位患者每年 14843 欧元。成本驱动因素是生产力损失（7037 欧元）和医疗费用（4621 欧元）。症状更严重的 DCM（即 NYHA 心功能分级 III 或 IV 级）患者的年平均 DCM 成本显著高于症状较轻的 DCM 患者（31099 欧元比 11446 欧元，P<0.001），且效用值显著更低（0.631 比 0.883，P<0.001）。
DCM 与高社会成本和降低的 QoL 相关，特别是与高 DCM 严重程度相关。
