拉丁美洲慢性心力衰竭患者的医疗保险和临床结果:哥伦比亚心力衰竭登记处(RECOLFACA)的观察研究

IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Carlos Andrés Plata, Clara Saldarriaga, Luis Eduardo Echeverría, Jorge Alberto Sandoval-Luna, Alexis Llamas, Gustavo Adolfo Moreno-Silgado, Julián Vanegas-Eljach, Nelson Eduardo Murillo-Benítez, Ricardo Gómez-Palau, Carlos Andrés Arias-Barrera, Fernán Mendoza-Beltrán, Diego Hernán Hoyos-Ballesteros, Juan Carlos Ortega-Madariaga, Alex Rivera-Toquica, Juan Esteban Gómez-Mesa
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引用次数: 0

摘要

在哥伦比亚和拉丁美洲,人们对医疗保险类型对心力衰竭(HF)患者预后的影响知之甚少。我们的目的是分析参加哥伦比亚心力衰竭登记处(RECOLFACA)的心力衰竭患者在医疗保险类型方面的特征,以及这些特征与患者近期预后的关系。2017-2019 年间,RECOLFACA 登记处纳入了确诊为心衰的患者。该登记在哥伦比亚的 60 个中心进行。全因死亡率是主要结果。为评估医疗保险对死亡率的影响,采用了 Cox 比例危险回归模型。卡普兰-梅耶分析用于比较不同保险类型的生存概率。所有统计分析均采用双尾法,P 值大于或等于 0.05 即为显著。在登记在册的2528名参与者中,99%的人拥有医疗保险的详细信息。其中,897 名患者(35.6%)参加了公共保险。与私人保险患者相比,这些患者明显更年轻,男性比例更低,更多来自农村,大多数合并症(不包括高血压、慢性阻塞性肺病(COPD)和南美锥虫病)的发病率也更低。此外,公共保险患者的功能分级较差,生活质量较低,使用植入式设备的频率也较低,但三联高血压药物治疗的处方率相似。最后,两组患者的短期死亡率没有差异(HR 1.09;95% CI 0.79-1.51)。在哥伦比亚,医疗保险类型与心房颤动患者概况的相关差异有关。尽管如此,这些患者的短期预后并未因医疗保险类型而出现明显差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Health insurance and clinical outcomes in patients with chronic heart failure in Latin America: an observational study of the Colombian Heart Failure Registry (RECOLFACA)

Health insurance and clinical outcomes in patients with chronic heart failure in Latin America: an observational study of the Colombian Heart Failure Registry (RECOLFACA)

The effect of the health insurance type on the prognosis of heart failure (HF) patients in Colombia and Latin America is poorly known. We aimed to analyze the characteristics of HF patients that participated in the Colombian Heart Failure Registry (RECOLFACA) as stated by their health insurance type and their relationship with the immediate prognosis of these patients. Patients with HF diagnosis were included in the RECOLFACA registry between 2017–2019. The registry was conducted in 60 centers in Colombia. All-cause mortality was the principal outcome. To evaluate the impact of health insurance on mortality, a Cox proportional hazards regression model was used. The Kaplan–Meier analysis was performed to compare survival probabilities according to insurance type. All statistical analyses were two-tailed and were considered significant with a p value < 0.05. Of the 2,528 participants enrolled in the registry, 99% held details about their health insurance. Of those, 897 patients (35.6%) were covered by public insurance. These patients were significantly younger, with a lower proportion of men, more frequently from rural origin, and lower prevalence of most comorbidities (omitting hypertension, chronic obstructive pulmonary disease (COPD), and Chagas disease) than those with private insurance. Furthermore, patients with public insurance had a worse functional class, as well as a poorer quality of life, and lower frequency of use of implantable devices, while exhibiting similar prescription rates of triple medical therapy for HF. Finally, no differences in short-term mortality were observed between the two groups (HR 1.09; 95% CI 0.79, 1.51). The type of health insurance represents a condition related with relevant differences in the profile of patients with HF in Colombia. Despite this, no significant differences were detected in the short-term prognosis of these patients based on the type of health insurance.

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来源期刊
Heart and Vessels
Heart and Vessels 医学-外周血管病
CiteScore
3.10
自引率
13.30%
发文量
211
审稿时长
2 months
期刊介绍: Heart and Vessels is an English-language journal that provides a forum of original ideas, excellent methods, and fascinating techniques on cardiovascular disease fields. All papers submitted for publication are evaluated only with regard to scientific quality and relevance to the heart and vessels. Contributions from those engaged in practical medicine, as well as from those involved in basic research, are welcomed.
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