Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Hypertens Res. 2024 Oct;47(10):2847-2854. doi: 10.1038/s41440-024-01853-x. Epub 2024 Aug 21.
We assessed the trends, characteristics, and consequences of potentially avoidable hospitalizations (PAH) for hypertension in Switzerland, for the period 1998 to 2018. Data from 117,507 hospitalizations (62.1% women), minimum age 20 years. Hospitalizations with hypertension as the main cause for admission were eligible. PAH for hypertension was defined according to the Organization for Economic Cooperation and Development criteria. The age-standardized rates of PAH for hypertension increased from 43 in 1998 to 81 per 100,000 in 2004, to decrease to 57 per 100,000 inhabitants in 2018. Compared to non-PAH, patients with PAH for hypertension were younger, more frequently women (66.9% vs. 56.7%), non-Swiss nationals (15.9% vs. 10.9%), were more frequently admitted as an emergency (78.9% vs. 59.5%), and by the patient's initiative (33.1% vs. 14.1%). Patients with PAH had also fewer comorbidities, as per the Charlson's index. Patients with PAH for hypertension were more frequently hospitalized in a semi-private or private setting, stayed less frequently in the intensive care unit (4.6% vs. 7.3%), were discharged more frequently home (91.4% vs. 73.0%), and had a shorter length of stay than patients with non-PAH for hypertension: median and [interquartile range] 5 [3-8] vs. 9 [4-15] days. In 2018, the total costs of PAH were estimated at 16.5 million CHF, corresponding to a median cost of 4936 [4445-4961] Swiss Francs per stay. We conclude that in Switzerland, PAH have increased, represent a considerable fraction of hospitalizations for hypertension, and carry a non-negligible health cost.
我们评估了 1998 年至 2018 年期间瑞士因高血压导致的可避免住院治疗(PAH)的趋势、特征和后果。数据来自 117507 例(62.1%为女性)、最小年龄 20 岁的住院患者。因高血压而入院的主要原因的住院患者符合条件。根据经济合作与发展组织(OECD)的标准,高血压的可避免住院治疗被定义为 PAH。高血压的 PAH 标准化发病率从 1998 年的 43 例/10 万人增加到 2004 年的 81 例/10 万人,然后下降到 2018 年的 57 例/10 万人。与非 PAH 患者相比,PAH 高血压患者年龄更小,女性比例更高(66.9% vs. 56.7%),非瑞士国民比例更高(15.9% vs. 10.9%),急诊入院比例更高(78.9% vs. 59.5%),且更倾向于主动住院(33.1% vs. 14.1%)。根据 Charlson 指数,PAH 患者的合并症也更少。高血压的 PAH 患者更多地住院于半私人或私人病房,较少在重症监护病房(4.6% vs. 7.3%),更多地出院回家(91.4% vs. 73.0%),且住院时间比非 PAH 高血压患者短:中位数和[四分位间距] 5 [3-8] 天 vs. 9 [4-15] 天。2018 年,PAH 的总费用估计为 1650 万瑞士法郎,相当于每次住院费用中位数为 4936 瑞士法郎[4445-4961]。我们得出结论,在瑞士,PAH 有所增加,占高血压住院治疗的相当大比例,并带来了不可忽视的健康成本。