中国特发性肺纤维化患者的直接经济负担
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摘要
目的评估特发性肺纤维化(idiopathic pulmonary fibrosis, IPF)患者的经济负担,为医疗保险及卫生政策制定提供参考依据。方法基于2013—2017年4家医院的电子医疗病历系统数据,对IPF及相关合并症的直接医疗费用和卫生资源利用情况进行统计分析。患者的纳排标准根据文献检索和IPF临床指南制定。采用描述性统计方法分析患者的经济负担,并将所有费用指标根据医疗卫生类价格指数调整至2017年。结果 4家医院共纳入386例IPF患者,共计562住院例次,人均住院次数为1.5次,患者中位住院费用为12 695元,次均住院时间为10.4 d。IPF合并急性呼吸道事件或其他疾病患者的中位住院费用高于单纯IPF住院患者。结论 IPF患者的经济负担较重,相关合并症或急性加重事件的发生将进一步增加患者的经济负担,需采取有效治疗措施延缓IPF疾病进展,减少相关合并症或急性加重发生,减轻患者的经济负担。
Objectives To evaluate the economic burden of patients in Idiopathic Pulmonary Fibrosis(IPF) in China and provide scientific reference for health insurance and health policy. Methods A retrospective analysis was performed with existing electronic medical records(EMR) data from 2013-2017 in 4 hospitals to estimate the direct medical cost and health care resource utilization of IPF patients. The inclusion and exclusion criteria were formulated based on literature and clinical treatment guidelines of IPF. Descriptive statistical methods were used to analyze the economic burden of patients and all cost indicators were adjusted to 2017 based on the health price index. Results A total of 386 IPF patients in the 4 tertiary hospitals were included in the analysis., with a total of 562 hospitalizations. The number of hospitalizations per capita was 1.5 times, with the median cost per hospitalization of 12,695 yuan, and the average hospitalization days of 10.4 d. Those IPF patients had 562 hospitalizations. The median costs per hospitalization of IPF patients in acute respiratory-related events or other diseases were higher than the ones without any comorbity. Conclusions The economic burden of patients with IPF is heavy, and the occurrence of related complications or acute exacerbation events will further increase the financial burden of patients. Effective measures should be taken to slow disease progression and reduce comorbities acute events associated with IPF as well as to the economic burden.
Objectives To evaluate the economic burden of patients in Idiopathic Pulmonary Fibrosis(IPF) in China and provide scientific reference for health insurance and health policy. Methods A retrospective analysis was performed with existing electronic medical records(EMR) data from 2013-2017 in 4 hospitals to estimate the direct medical cost and health care resource utilization of IPF patients. The inclusion and exclusion criteria were formulated based on literature and clinical treatment guidelines of IPF. Descriptive statistical methods were used to analyze the economic burden of patients and all cost indicators were adjusted to 2017 based on the health price index. Results A total of 386 IPF patients in the 4 tertiary hospitals were included in the analysis., with a total of 562 hospitalizations. The number of hospitalizations per capita was 1.5 times, with the median cost per hospitalization of 12,695 yuan, and the average hospitalization days of 10.4 d. Those IPF patients had 562 hospitalizations. The median costs per hospitalization of IPF patients in acute respiratory-related events or other diseases were higher than the ones without any comorbity. Conclusions The economic burden of patients with IPF is heavy, and the occurrence of related complications or acute exacerbation events will further increase the financial burden of patients. Effective measures should be taken to slow disease progression and reduce comorbities acute events associated with IPF as well as to the economic burden.
引文
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[12]Guo J,Li B,Li W,et al.Chinese herbal medicines compared with N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis:Protocol for a systematic review[J].Medicine(Baltimore),2018,97(44):e13077.
[13]Fleetwood K,McCool R,Glanville J,et al.Systematic Review and Network Meta-analysis of Idiopathic Pulmonary Fibrosis Treatments[J].J Manag Care Spec Pharm,2017,23(3):S5-S16.
[14]Collard HR,Ryerson CJ,Corte TJ,et al.Acute Exacerbation of Idiopathic Pulmonary Fibrosis.An International Working Group Report[J].Am J Respir Crit Care Med,2016,194(3):265-275.
[2]王柳盛,李惠萍.中国大陆间质性肺疾病流行病学资料及研究进展[J].中华内科杂志,2014,53(8):652-654.
[3]Kamiya H,Panlaqui OM.Prognostic factors for acute exacerbation of idiopathic pulmonary fibrosis:protocol for a systematic review and meta-analysis[J].BMJ Open,2019,9(5):e028226.
[4]蔡后荣.2011年特发性肺纤维化诊断和治疗循证新指南解读[J].中国呼吸与危重监护杂志,2011,10(4):313-316.
[5]魏路清,彭守春,曹洁,等.弥漫性间质性肺疾病的临床特征及诊治方法的多中心研究[J].中国全科医学,2012,15(22):2521-2524.
[6]郑小芬.特发性肺纤维化住院患者直接医疗经济负担研究[D].北京:首都医科大学,2017.
[7]Cottin V,Schmidt A,Catella L,et al.Burden of Idiopathic Pulmonary Fibrosis Progression:A 5-Year Longitudinal Follow-Up Study[J].PLoS One,2017,12(1):e0166462.
[8]中华医学会呼吸病学分会间质性肺疾病学组.特发性肺纤维化诊断和治疗中国专家共识[J].中华结核和呼吸杂志,2016,39(6):427-432.
[9]Yu YF,Wu N,Chuang CC,et al.Patterns and Economic Burden of Hospitalizations and Exacerbations Among Patients Diagnosed with Idiopathic Pulmonary Fibrosis[J].J Manag Care Spec Pharm,2016,22(4):414-423.
[10]Kim SW,Myong JP,Yoon HK,et al.Health care burden and medical resource utilisation of idiopathic pulmonary fibrosis in Korea[J].Int J Tuberc Lung Dis,2017,21(2):230-235.
[11]Richeldi L,Baldi F,Pasciuto G,et al.Current and Future Idiopathic Pulmonary Fibrosis Therapy[J].Am J Med Sci,2019,357(5):370-373.
[12]Guo J,Li B,Li W,et al.Chinese herbal medicines compared with N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis:Protocol for a systematic review[J].Medicine(Baltimore),2018,97(44):e13077.
[13]Fleetwood K,McCool R,Glanville J,et al.Systematic Review and Network Meta-analysis of Idiopathic Pulmonary Fibrosis Treatments[J].J Manag Care Spec Pharm,2017,23(3):S5-S16.
[14]Collard HR,Ryerson CJ,Corte TJ,et al.Acute Exacerbation of Idiopathic Pulmonary Fibrosis.An International Working Group Report[J].Am J Respir Crit Care Med,2016,194(3):265-275.