背景:据报道,长期氧疗(LTOT)可提高慢性呼吸衰竭患者的生存率。我们的目的是描述有效性,负担,与其他LTOT选项相比,使用便携式氧气浓缩器(POC)治疗的患者的疾病成本。
方法:根据法国国家医疗保健数据库SNDS,这项回顾性比较分析包括2014年至2019年首次接受LTOT并随访至2020年12月的慢性呼吸功能不全和衰竭(CRF)的成年患者。使用POC的患者,单独或组合,与单独使用固定浓缩器(aSC)的患者进行比较,或压缩罐(CTC)或液氧(LO2),根据年龄匹配,性别,合并症,和固定式浓缩器使用。
结果:在244,719名LTOT患者(平均年龄75±12岁,48%为女性)中,38%使用ASC,46%的流动氧以LO2(38%)和POC(18%)的形式存在,而9%使用CTC。在72个月的随访中,死亡风险估计为13%。15%,与aSC相比,POC组的患者低12%,反恐委员会,和LO2,分别。在POC组中,与aSC和CTC组相比,每位患者的年平均总费用高5%,低4%。分别,在LO2组中具有可比性。与ASC相比,POC的增量成本效益比(ICER)为8895欧元,6288欧元和每年获得的13,152欧元,反恐委员会,和LO2,分别。
结论:在POC组中,我们检测到较高的流动性(POC自主性高于5小时),提高生存率,更低的成本,和ICER-6238欧元,相比之下,移动性较低的POC用户。
BACKGROUND: Long-term oxygen therapy (LTOT) is reported to improve survival in patients with chronic respiratory failure. We aimed to describe effectiveness, burden, and cost of illness of patients treated with portable oxygen concentrators (POC) compared to other LTOT options.
METHODS: This retrospective comparative analysis included adult patients with chronic respiratory insufficiency and failure (CRF) upon a first delivery of LTOT between 2014 and 2019 and followed until December 2020, based on the French national healthcare database SNDS. Patients using POC, alone or in combination, were compared with patients using stationary concentrators alone (aSC), or compressed tanks (CTC) or liquid oxygen (LO2), matched on the basis of age, gender, comorbidities, and stationary concentrator use.
RESULTS: Among 244,719 LTOT patients (mean age 75 ± 12, 48% women) included, 38% used aSC, 46% mobile oxygen in the form of LO2 (29%) and POC (18%), whereas 9% used CTC. The risk of death over the 72-month follow-up was estimated to be 13%, 15%, and 12% lower for patients in the POC group compared to aSC, CTC, and LO2, respectively. In the POC group yearly mean total costs per patient were 5% higher and 4% lower compared to aSC and CTC groups, respectively, and comparable in the LO2 group. The incremental cost-effectiveness ratio (ICER) of POC was €8895, €6288, and €13,152 per year of life gained compared to aSC, CTC, and LO2, respectively.
CONCLUSIONS: Within the POC group, we detected an association between higher mobility (POCs autonomy higher than 5 h), improved survival, lower costs, and ICER - €6 238, compared to lower mobility POCs users.