系统性硬化症确诊前全科医生和医院的医疗保健使用情况:一项全国范围的登记研究。

IF 4.7 2区 医学 Q1 RHEUMATOLOGY
Fie J Praastrup, Annette de Thurah, Ellen M Hauge, Linda A Rasmussen, Esben U Næser
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引用次数: 0

摘要

目的:系统性硬化症(SSc)在确诊时往往存在不可逆的组织损伤,因此需要尽早诊断。本研究估算了系统性硬化症确诊前三年的医疗保健使用情况:我们利用丹麦国家登记处的数据开展了一项基于人群的队列研究。2005年1月1日至2018年12月31日期间确诊为SSc的事件患者按年龄和性别与10名无SSc的参照者进行了匹配。诊断日期为索引日期。我们估算了SSc患者及其参照者在确诊前三年的季度率和调整后的发病率比(IRR)及95%置信区间(CI):共纳入 1,650 名 SSc 患者(1,255 名女性和 395 名男性)和 16,500 名非 SSc 参考者。平均年龄为 58 岁(四分位数间距为 48-68)。确诊前三年,与参考者相比,SSc 患者与全科医生(女性 IRR= 1.43 [95% CI: 1.33; 1.53],男性 IRR= 1.47 [95% CI: 1.26; 1.71])和医院(女性 IRR= 1.86 [95% CI: 1.62; 2.14],男性 IRR= 2.70 [95% CI: 2.04; 3.58])的接触更多。在确诊前的最后三个月,SSc 患者与全科医生(女性 IRR= 2.30 [95% CI: 2.16; 2.44],男性 IRR= 2.98 [95% CI: 2.64; 3.35])和医院(女性 IRR= 5.62 [95% CI: 5.08; 6.20],男性 IRR= 9.53 [95% CI: 7.81; 11.63])的接触明显增多:在确诊前的三年中,全科医生和医院的医疗服务使用率较高,这表明有机会促进 SSc 的早期诊断和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Healthcare utilization in general practice and hospitals preceding a diagnosis of systemic sclerosis: a nationwide registry study.

Objectives: Irreversible tissue damage is frequently present at the time of diagnosis in systemic sclerosis (SSc), which calls for earlier diagnosis. This study estimated healthcare utilization three years before the diagnosis of SSc.

Methods: We conducted a population-based cohort study using data from Danish national registries. Incident patients diagnosed with SSc between January 1, 2005, and December 31, 2018, were matched by age and gender with 10 references without SSc. The date of diagnosis was the index date. We estimated quarterly rates and adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CI) of healthcare utilization in the three years preceding the diagnosis for patients with SSc and their references.

Results: A total of 1,650 SSc patients (1,255 women and 395 men) and 16 500 non-SSc references were included. The mean age was 58 years (interquartile range 48-68). Three years before diagnosis, patients with SSc had more contacts with general practice (IRRwomen= 1.43 [95% CI: 1.33; 1.53], IRRmen= 1.47 [95% CI: 1.26; 1.71]) and hospitals (IRRwomen= 1.86 [95% CI: 1.62; 2.14], IRRmen= 2.70 [95% CI: 2.04; 3.58]) compared with their references. In the last three months before diagnosis, patients with SSc had significantly more contacts with general practice (IRRwomen= 2.30 [95% CI: 2.16; 2.44], IRRmen= 2.98 [95% CI: 2.64; 3.35]) and hospitals (IRRwomen= 5.62 [95% CI: 5.08; 6.20], IRRmen= 9.53 [95% CI: 7.81; 11.63]).

Conclusion: The higher use of healthcare services in general practice and hospitals in the three years before diagnosis suggests an opportunity to facilitate earlier diagnosis and treatment of SSc.

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来源期刊
Rheumatology
Rheumatology 医学-风湿病学
CiteScore
9.40
自引率
7.30%
发文量
1091
审稿时长
2 months
期刊介绍: Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.
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