{"title":"PP78 韩国经导管主动脉瓣植入术后脑卒中的真实世界趋势和医疗成本:一项基于人口的全国性研究","authors":"Sujin Jung, Hyewon Nam, Schezn Lim, Jae H. Choi","doi":"10.1017/s0266462324000126","DOIUrl":null,"url":null,"abstract":"\n \n Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis. While procedural advancements have reduced the risk of stroke, stroke remains a serious complication of TAVI. To date, no study has investigated post-TAVI stroke costs in Korea. This study compared medical costs between patients with and without stroke after TAVI.\n \n \n \n This was a retrospective study using claims data from the Korean Health Insurance Review and Assessment Service. Patients who underwent TAVI in certified hospitals between June 2015 and December 2020 were included; patients with SAVR prior to TAVI were excluded. Patients with postoperative stroke within 30 days of TAVI formed the “Stroke” group; remaining patients formed the “Non-Stroke” group. A generalized linear model with adjustment was used to compare mean medical costs in the first year after TAVI between the two groups. Exchange rate from xe.com (5 December 2022) was applied.\n \n \n \n In total, 3,046 TAVI patients were included for analysis (47% male, 85% aged ≥ 75 years). There were 61 (2%) patients in the “Stroke” group and 2,985 (98%) in the “Non-Stroke” group. Compared to the “Non-Stroke” group, the “Stroke” group had significantly higher adjusted mean total first-year medical costs (KRW 25,453,725 (95% confidence interval (CI):15,215,439-42,581,231) (USD 19,640 (95% CI:11,740-32,856)) vs. KRW 19,169,447 (95% CI:11,818,973-31,091,340) (USD 14,791 (95% CI:9,120-23,990)), p < 0.01). Of these costs, 90 percent (“Stroke”) and 84 percent (“Non-Stroke”) were hospitalization-related (“Stroke” vs. “Non-Stroke”: KRW 6,847,975 (USD 5,284); p < 0.01); the remainder were outpatient costs. Predictors of total medical costs were gender; hospital type; prior chronic obstructive pulmonary disease; prior diabetes; prior stroke; and postoperative stroke.\n \n \n \n In Korea, TAVI patients with stroke had higher first-year medical costs compared to those without stroke, driven by hospitalization costs. Stroke poses an immediate, heavy economic burden on healthcare systems. Longer-term (e.g., caregiver, rehabilitation) costs were not captured in this analysis; future studies are needed to provide supplementary evidence on the total economic burden of stroke.\n","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"PP78 Real-World Trends And Medical Costs Of Stroke After Transcatheter Aortic Valve Implantation In Korea: A Nationwide, Population-Based Study\",\"authors\":\"Sujin Jung, Hyewon Nam, Schezn Lim, Jae H. Choi\",\"doi\":\"10.1017/s0266462324000126\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis. While procedural advancements have reduced the risk of stroke, stroke remains a serious complication of TAVI. To date, no study has investigated post-TAVI stroke costs in Korea. This study compared medical costs between patients with and without stroke after TAVI.\\n \\n \\n \\n This was a retrospective study using claims data from the Korean Health Insurance Review and Assessment Service. Patients who underwent TAVI in certified hospitals between June 2015 and December 2020 were included; patients with SAVR prior to TAVI were excluded. Patients with postoperative stroke within 30 days of TAVI formed the “Stroke” group; remaining patients formed the “Non-Stroke” group. A generalized linear model with adjustment was used to compare mean medical costs in the first year after TAVI between the two groups. Exchange rate from xe.com (5 December 2022) was applied.\\n \\n \\n \\n In total, 3,046 TAVI patients were included for analysis (47% male, 85% aged ≥ 75 years). There were 61 (2%) patients in the “Stroke” group and 2,985 (98%) in the “Non-Stroke” group. Compared to the “Non-Stroke” group, the “Stroke” group had significantly higher adjusted mean total first-year medical costs (KRW 25,453,725 (95% confidence interval (CI):15,215,439-42,581,231) (USD 19,640 (95% CI:11,740-32,856)) vs. KRW 19,169,447 (95% CI:11,818,973-31,091,340) (USD 14,791 (95% CI:9,120-23,990)), p < 0.01). Of these costs, 90 percent (“Stroke”) and 84 percent (“Non-Stroke”) were hospitalization-related (“Stroke” vs. “Non-Stroke”: KRW 6,847,975 (USD 5,284); p < 0.01); the remainder were outpatient costs. Predictors of total medical costs were gender; hospital type; prior chronic obstructive pulmonary disease; prior diabetes; prior stroke; and postoperative stroke.\\n \\n \\n \\n In Korea, TAVI patients with stroke had higher first-year medical costs compared to those without stroke, driven by hospitalization costs. Stroke poses an immediate, heavy economic burden on healthcare systems. Longer-term (e.g., caregiver, rehabilitation) costs were not captured in this analysis; future studies are needed to provide supplementary evidence on the total economic burden of stroke.\\n\",\"PeriodicalId\":14467,\"journal\":{\"name\":\"International Journal of Technology Assessment in Health Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-05-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Technology Assessment in Health Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/s0266462324000126\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Technology Assessment in Health Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/s0266462324000126","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
PP78 Real-World Trends And Medical Costs Of Stroke After Transcatheter Aortic Valve Implantation In Korea: A Nationwide, Population-Based Study
Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis. While procedural advancements have reduced the risk of stroke, stroke remains a serious complication of TAVI. To date, no study has investigated post-TAVI stroke costs in Korea. This study compared medical costs between patients with and without stroke after TAVI.
This was a retrospective study using claims data from the Korean Health Insurance Review and Assessment Service. Patients who underwent TAVI in certified hospitals between June 2015 and December 2020 were included; patients with SAVR prior to TAVI were excluded. Patients with postoperative stroke within 30 days of TAVI formed the “Stroke” group; remaining patients formed the “Non-Stroke” group. A generalized linear model with adjustment was used to compare mean medical costs in the first year after TAVI between the two groups. Exchange rate from xe.com (5 December 2022) was applied.
In total, 3,046 TAVI patients were included for analysis (47% male, 85% aged ≥ 75 years). There were 61 (2%) patients in the “Stroke” group and 2,985 (98%) in the “Non-Stroke” group. Compared to the “Non-Stroke” group, the “Stroke” group had significantly higher adjusted mean total first-year medical costs (KRW 25,453,725 (95% confidence interval (CI):15,215,439-42,581,231) (USD 19,640 (95% CI:11,740-32,856)) vs. KRW 19,169,447 (95% CI:11,818,973-31,091,340) (USD 14,791 (95% CI:9,120-23,990)), p < 0.01). Of these costs, 90 percent (“Stroke”) and 84 percent (“Non-Stroke”) were hospitalization-related (“Stroke” vs. “Non-Stroke”: KRW 6,847,975 (USD 5,284); p < 0.01); the remainder were outpatient costs. Predictors of total medical costs were gender; hospital type; prior chronic obstructive pulmonary disease; prior diabetes; prior stroke; and postoperative stroke.
In Korea, TAVI patients with stroke had higher first-year medical costs compared to those without stroke, driven by hospitalization costs. Stroke poses an immediate, heavy economic burden on healthcare systems. Longer-term (e.g., caregiver, rehabilitation) costs were not captured in this analysis; future studies are needed to provide supplementary evidence on the total economic burden of stroke.
期刊介绍:
International Journal of Technology Assessment in Health Care serves as a forum for the wide range of health policy makers and professionals interested in the economic, social, ethical, medical and public health implications of health technology. It covers the development, evaluation, diffusion and use of health technology, as well as its impact on the organization and management of health care systems and public health. In addition to general essays and research reports, regular columns on technology assessment reports and thematic sections are published.