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哮喘患者死亡前的经济负担:一项全国性描述性研究。

The economic burden of asthma prior to death: a nationwide descriptive study.

机构信息

Pôle des voies respiratoires, service de pneumo-allergologie, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.

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

出版信息

Front Public Health. 2024 Feb 19;12:1191788. doi: 10.3389/fpubh.2024.1191788. eCollection 2024.

Abstract

BACKGROUND

In addition to the clinical burden, asthma is responsible for a high economic burden. However, little is known about the economic burden of asthma prior to death.

OBJECTIVE

We performed an economic analysis to describe the costs during 12 and 24 months prior to asthma death between 2013 and 2017 in France.

METHODS

An observational cohort study was established using the French national health insurance database. Direct medical and non-medical costs, as well as costs related to absence from the workplace, were included in the analysis.

RESULTS

In total, 3,829 patients were included in the final analysis. Over 24 and 12 months prior to death, total medical costs per patient were €27,542 [26,545-28,641] and €16,815 [16,164-17,545], respectively. Total medical costs clearly increased over 24 months prior to death. Over 12 months prior to death, costs increased significantly according to age categories, with mean total costs of €8,592, €15,038, and €17,845, respectively, for the categories <18 years old, 18-75 years old, and 75+ years old ( < 0.0001). Over 12 months prior to death, costs were statistically higher in patients with a dispensation of six or more SABA canisters compared to those with a dispensation of five or less canisters ( < 0.0001). In multivariate analysis, comorbidities, hospital as location of death, and dispensation of 12 or more canisters of SABA per year are independent factors of the highest costs.

CONCLUSION

To conclude, the economic burden of asthma death is high and increases with time, age, and SABA dispensation.

摘要

背景

除了临床负担外,哮喘还会带来沉重的经济负担。然而,人们对哮喘患者死亡前的经济负担知之甚少。

目的

我们进行了一项经济分析,以描述 2013 年至 2017 年期间法国哮喘死亡前 12 个月和 24 个月的成本。

方法

使用法国国家健康保险数据库进行了一项观察性队列研究。分析中包括直接医疗和非医疗成本,以及与旷工相关的成本。

结果

共有 3829 名患者纳入最终分析。在死亡前 24 个月和 12 个月,每位患者的总医疗费用分别为 27542 欧元[26545-28641]和 16815 欧元[16164-17545]。在死亡前 24 个月,总医疗费用明显增加。在死亡前 12 个月,根据年龄类别,总费用显著增加,<18 岁、18-75 岁和 75 岁以上的患者的平均总费用分别为 8592 欧元、15038 欧元和 17845 欧元( <0.0001)。在死亡前 12 个月,使用 6 个或更多 SABA 小瓶的患者的费用明显高于使用 5 个或更少小瓶的患者( <0.0001)。在多变量分析中,合并症、死亡地点为医院以及每年使用 12 个或更多 SABA 小瓶是费用最高的独立因素。

结论

总之,哮喘死亡的经济负担很高,且随时间、年龄和 SABA 分配而增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10909909/7922bc5017cb/fpubh-12-1191788-g001.jpg

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