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瑞典转甲状腺素蛋白淀粉样变心肌病的医疗资源利用、诊断延迟和疾病负担。

Health care resource use, diagnostic delay and disease burden in transthyretin amyloid cardiomyopathy in Sweden.

机构信息

The Swedish Institute for Health Economics, Lund, Sweden.

Pfizer AB, Stockholm, Sweden.

出版信息

Ann Med. 2023;55(2):2292686. doi: 10.1080/07853890.2023.2292686. Epub 2023 Dec 14.

Abstract

AIMS

To estimate healthcare resource use and direct healthcare costs of Transthyretin Amyloid Cardiomyopathy (ATTR-CM) in Sweden over 12 months across severity stages as defined by the New York Heart Association (NYHA). Secondary to investigate the current diagnostic trajectory for patients with ATTR-CM in Sweden.

METHODS

A stratified inclusion of patients with a confirmed diagnosis of ATTR-CM in different NYHA classes. Data was extracted from medical records in two cardiology clinics in Sweden. Healthcare resource use data were retrospectively collected for 12 months.

RESULTS

38 patients were included, of whom 7 were in NYHA class II, 20 in class III and 4 in class IV. The total cost of health care per patient increased from SEK 69,000 (€6800) in NYHA stage II, SEK 219,000 (€21,500) in NYHA stage III, to SEK 638,000 (€62,900) in stage IV, mainly due to an increase in inpatient stays. Mean time (standard deviation, SD) from any cardiac related diagnosis prior to ATTR-CM diagnosis was 3.5 (3.1) years.

CONCLUSIONS

Advanced ATTR-CM stages are associated with significant healthcare costs, as patients more often require resource-intensive inpatient care. The current diagnostic trajectory of ATTR-CM in this study was characterized by a diagnostic delay of several years.

摘要

目的

评估瑞典在纽约心脏协会(NYHA)定义的不同严重程度阶段(1 至 4 级)下,12 个月内转甲状腺素蛋白淀粉样心肌病(ATTR-CM)的医疗资源利用和直接医疗费用。次要目的是调查瑞典ATTR-CM 患者的当前诊断轨迹。

方法

按不同 NYHA 级别的确诊 ATTR-CM 患者分层纳入。数据从瑞典两家心脏病诊所的病历中提取。回顾性收集 12 个月的医疗资源使用数据。

结果

共纳入 38 名患者,其中 7 名处于 NYHA Ⅱ级,20 名处于 NYHA Ⅲ级,4 名处于 NYHA Ⅳ级。每位患者的医疗保健总成本从 NYHA Ⅱ级的 69,000 瑞典克朗(6800 欧元)增加到 NYHA Ⅲ级的 219,000 瑞典克朗(21,500 欧元),再增加到 NYHA Ⅳ级的 638,000 瑞典克朗(62,900 欧元),主要是由于住院次数增加所致。从任何与心脏相关的诊断到 ATTR-CM 诊断之前的平均时间(标准差,SD)为 3.5(3.1)年。

结论

晚期 ATTR-CM 阶段与显著的医疗保健成本相关,因为患者更经常需要资源密集型住院治疗。本研究中 ATTR-CM 的当前诊断轨迹的特点是存在数年的诊断延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/651a/10732175/90cd28ccd5b5/IANN_A_2292686_F0001_C.jpg

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