Sowa P Marcin, Mallett Andrew J, Connelly Luke B
Centre for the Business and Economics of Health, The University of Queensland, St Lucia, Queensland, Australia.
NHMRC Chronic Kidney Disease Centre of Research Excellence, The University of Queensland, Herston, Queensland, Australia.
Genet Med Open. 2024 Jul 25;2:101876. doi: 10.1016/j.gimo.2024.101876. eCollection 2024.
There is increasing recognition of monogenic aetiologies for kidney disease. We sought to identify whether genetic kidney disease (GKD) has distinct hospitalization patterns compared to other forms of chronic kidney disease (CKD).
Health service utilization analysis was undertaken in a CKD cohort study across public hospital services in Queensland, Australia. CKD due to clinically coded potential monogenic causes was compared to all other causes in terms of annual frequency, cost, and type of hospital admission.
We analyzed 7 years of hospital admissions data (809,188 admissions) among 29,046 patients. Compared to non-genetic CKD, GKD was associated with a higher likelihood and cost of admissions. GKD had consistently more admissions (mean excess annual number of admissions increasing from 5.2 in year 1 to 13.4 in year 7) and more costly admissions (mean excess annual cost increasing from $5,265 in year 1 to $12,993 in year 7). This gap in hospitalization likelihood and cost increased over time for both surgical and medical admission episodes, but not for all (immunological, cancer) causes of admissions.
Understanding the nature and extent of differences in healthcare needs between GKD and other CKD will enable better secondary prevention and inform resource allocation decisions to reduce healthcare system pressures attributable to knowable causes.
人们对肾脏疾病的单基因病因的认识日益增加。我们试图确定与其他形式的慢性肾脏病（CKD）相比，遗传性肾脏病（GKD）是否具有独特的住院模式。
在澳大利亚昆士兰州公立医院服务的一项CKD队列研究中进行了卫生服务利用分析。将临床编码的潜在单基因病因导致的CKD与所有其他病因在年度发生率、费用和住院类型方面进行比较。
我们分析了29,046例患者7年的住院数据（809,188次住院）。与非遗传性CKD相比，GKD与更高的住院可能性和费用相关。GKD的住院次数一直更多（每年平均额外住院次数从第1年的5.2次增加到第7年的13.4次），住院费用也更高（每年平均额外费用从第1年的5265美元增加到第7年的12993美元）。手术和内科住院病例的住院可能性和费用差距随时间增加，但并非所有（免疫、癌症）住院病因都是如此。
了解GKD和其他CKD在医疗需求方面差异的性质和程度，将有助于更好地进行二级预防，并为资源分配决策提供信息，以减轻可归因于已知病因的医疗系统压力。
