Outpatient Treatment in Low-Risk Pulmonary Embolism Patients Receiving Direct Acting Oral Anticoagulants Is Associated With Cost Savings.
Outpatient Treatment in Low-Risk Pulmonary Embolism Patients Receiving Direct Acting Oral Anticoagulants Is Associated With Cost Savings.
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DOI：
10.1177/1076029620937352
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Gottsäter A
中科院分区：
文献类型：
--
作者：
Ghazvinian R;Elf J;Löfvendahl S;Holst J;Gottsäter A
直接口服抗凝剂（DOAC）是肺栓塞（PE）的一线治疗。急性PE的治疗传统上是以医院为基础的，并且与高成本相关。本研究的目的是评价低风险PE患者门诊DOAC治疗与住院DOAC治疗相比的潜在成本节约。一项在2013-2015年8家医院接受DOAC治疗的低风险PE（简化肺严重程度指数[sPESI] ≤ 1）患者中进行的回顾性研究。比较了223例（44%）门诊治疗患者和287例（56%）住院治疗患者的医疗保健费用。住院组每例患者的总费用为8293欧元，门诊组为2176欧元（p < 0.001）。在sPESI为0和1的两个亚组中，住院患者的总费用高于门诊患者（p < 0.001）。在多变量分析中，治疗类型（住院或门诊，p = < 0.001）和sPESI组（0或1，p = < 0.001）与低于或高于中位数的总成本相关，而年龄（p = 0.565）和性别（p = 0.177）则无关。遵循指南建议在低风险PE患者中使用DOAC进行门诊治疗，可以节省大量费用。
Direct oral anticoagulants (DOAC) are first line treatment for pulmonary embolism (PE). Treatment of acute PE is traditionally hospital based and associated with high costs. The aims of this study were to evaluate potential cost savings with outpatient DOAC treatment compared to inpatient DOAC treatment in patients with low risk PE. A retrospective study in patients with DOAC treated low risk PE (simplified pulmonary severity index [sPESI] ≤ 1) admitted to 8 hospitals during 2013-2015. Health care costs were compared in 223(44%) patients treated as outpatients and 287(56%) treated in hospital. Total cost per patient was 8293 EUR in the inpatient group, and 2176 EUR in the outpatient group (p < 0.001). Total costs for inpatients were higher (p < 0.001) compared to outpatients in both subgroups with sPESI 0 and 1. In multivariate analysis, type of treatment (in- or outpatient, p = < 0.001) and sPESI group (0 or 1, p = < 0.001) were associated with total cost below or above median, whereas age (p = 0.565) and gender (p = 0.177) was not. Adherence to guidelines recommending outpatient treatment with DOAC in patients with low risk PE enables significant savings.
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