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越南心力衰竭患者的年度经济负担:一项回顾性分析。

The annual economic burden incurred by heart failure patients in Vietnam: a retrospective analysis.

作者信息

Dao Tien Duc, Tran Hien Thi Bich, Vu Quynh Van, Nguyen Huong Thi Thanh, Nguyen Pol Van, Vo Trung Quang

机构信息

Military Hospital 175, Hochiminh City, Vietnam.

Faculty of Pharmacy, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.

出版信息

J Pharm Policy Pract. 2024 Jul 29;17(1):2381099. doi: 10.1080/20523211.2024.2381099. eCollection 2024.

Abstract

INTRODUCTION

Heart failure (HF) is a chronic condition associated with substantial mortality and hospitalisation, resulting in costly inpatient visits. The healthcare systems of several countries, including Vietnam, experience considerable difficulty in dealing with the enormous fiscal burden presented by HF. This study aims to analyse the direct medical costs associated with HF inpatient treatment from the hospital perspective.

MATERIALS AND METHODS

This study retrospectively analysed the electronic medical records of patients diagnosed with HF from 2018 to 2021 at Military Hospital 175 in Vietnam. The sample consisted of 906 hospitalised patients (mean age: 71.2 ± 14.1 years). The financial impact of HF was assessed by examining the direct medical expenses incurred by the healthcare system, and the costs of pharmaceutical categories used in treatment were explored.

RESULTS

The cumulative economic burden of HF from 2018 to 2021 was US$1,068,870, with annual costs ranging from US$201,670 to US$443,831. Health insurance covered 72.7% of these costs. Medications and infusions, and medical supplies accounted for the largest expenses, at 29.8% and 22.1%, respectively. The medication HF group accounted for 13.01% of these expenses, of which the costliest medications included nitrates (2.57%), angiotensin II receptor blockers (0.51%), ivabradine (0.39%), diuretics (0.24%), and mineralocorticoid receptor antagonists (0.23%). Comorbidities and the length of hospital stay significantly influenced annual treatment costs.

CONCLUSION

The study reveals that HF significantly impacts Vietnam's healthcare system and citizens, requiring a comprehensive understanding of its financial implications and efficient management of medical resources for those diagnosed. This study highlights the substantial economic burden of HF on Vietnam's healthcare system, with medication costs, particularly antithrombotic drugs, representing the largest expense. Most healthcare costs were covered by health insurance, and expenses were significantly influenced by comorbidity and length of hospital stay. These findings can inform healthcare policy, resource allocation and optimise management strategies in Vietnam.

摘要

引言

心力衰竭(HF)是一种慢性疾病,与高死亡率和住院率相关,导致住院费用高昂。包括越南在内的几个国家的医疗系统在应对心力衰竭带来的巨大财政负担方面面临相当大的困难。本研究旨在从医院角度分析与心力衰竭住院治疗相关的直接医疗费用。

材料与方法

本研究回顾性分析了2018年至2021年在越南第175军区医院被诊断为心力衰竭的患者的电子病历。样本包括906名住院患者(平均年龄:71.2±14.1岁)。通过检查医疗系统产生的直接医疗费用来评估心力衰竭的财务影响,并探讨治疗中使用的药品类别成本。

结果

2018年至2021年心力衰竭的累计经济负担为1,068,870美元,年度成本从201,670美元到443,831美元不等。医疗保险覆盖了这些费用的72.7%。药物和输液以及医疗用品的费用最高,分别占29.8%和22.1%。心力衰竭药物组占这些费用的13.01%,其中最昂贵的药物包括硝酸盐(2.57%)、血管紧张素II受体阻滞剂(0.51%)、伊伐布雷定(0.39%)、利尿剂(0.24%)和盐皮质激素受体拮抗剂(0.23%)。合并症和住院时间显著影响年度治疗费用。

结论

该研究表明,心力衰竭对越南的医疗系统和公民有重大影响,需要全面了解其财务影响并对确诊患者进行有效的医疗资源管理。本研究强调了心力衰竭对越南医疗系统的巨大经济负担,药品成本,特别是抗血栓药物,是最大的费用支出。大多数医疗费用由医疗保险支付,费用受合并症和住院时间的显著影响。这些发现可为越南的医疗政策、资源分配和优化管理策略提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85b1/11288205/53c8837ef78f/JPPP_A_2381099_F0001_OB.jpg

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