目标:检查直接和间接成本,提前退休,瑞典动脉粥样硬化性心血管疾病(ASCVD)患者和配对对照者5年以上的心血管事件和死亡率.
方法:在现有数据库中确定了2012年1月1日居住在瑞典的16岁以上的个体。ASCVD患者的倾向评分与无ASCVD患者的年龄匹配,性和教育状况。我们比较了直接医疗成本(住院,门诊费和药费),间接成本(因缺勤造成的)和中风的风险,心肌梗死(MI)和提前退休。
结果:匹配后,每个队列中有231,417人.与对照组相比,ASCVD组的人均年平均费用高出2.5倍以上(6923欧元vs2699欧元)。间接费用占ASCVD组和对照组年费用的60%和67%,分别。住院费用占直接医疗费用的70%以上。在5年期间,ASCVD组的累计总成本为32,011欧元,对照组为12,931欧元。ASCVD患者进入提前退休的可能性是对照组的3倍(风险比[HR]3.02[95%CI2.76-3.31]),中风(HR1.83[1.77-1.89])或MI(HR2.27[2.20-2.34])的约2倍。
结论:ASCVD与经济和临床影响有关。ASCVD患者的费用比匹配的对照组高得多,缺勤和住院导致的间接成本是主要的成本驱动因素,也更有可能经历额外的ASCVD事件。
To examine direct and indirect costs, early retirement, cardiovascular events and mortality over 5 years in people with atherosclerotic cardiovascular disease (ASCVD) and matched controls in Sweden.
Individuals aged ≥ 16 years living in Sweden on 01 January 2012 were identified in an existing database. Individuals with ASCVD were propensity score matched to controls without ASCVD by age, sex and educational status. We compared direct healthcare costs (inpatient, outpatient and drug costs), indirect costs (resulting from work absence) and the risk of stroke, myocardial infarction (MI) and early retirement.
After matching, there were 231,417 individuals in each cohort. Total mean per-person annual costs were over 2.5 times higher in the ASCVD group versus the controls (€6923 vs €2699). Indirect costs contributed to 60% and 67% of annual costs in the ASCVD and control groups, respectively. Inpatient costs accounted for ≥ 70% of direct healthcare costs. Cumulative total costs over the 5-year period were €32,011 in the ASCVD group and €12,931 in the controls. People with ASCVD were 3 times more likely to enter early retirement than controls (hazard ratio [HR] 3.02 [95% CI 2.76-3.31]) and approximately 2 times more likely to experience stroke (HR 1.83 [1.77-1.89]) or MI (HR 2.27 [2.20-2.34]).
ASCVD is associated with both economic and clinical impacts. People with ASCVD incurred considerably higher costs than matched controls, with indirect costs resulting from work absence and inpatient admissions being major cost drivers, and were also more likely to experience additional ASCVD events.