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Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertension

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Authors
Hwang, In-Chang; Cho, Goo-Yeong; Choi, Hong-Mi; Yoon, Yeonyee E; Park, Jin Joo; Park, Jun-Bean; Lee, Seung-Pyo; Kim, Hyung-Kwan; Kim, Yong-Jin; Sohn, Dae-Won
Issue Date
2019-10-30
Publisher
BMC
Citation
BMC Pulmonary Medicine, 19(1):189
Keywords
Pulmonary hypertensionHealthcare utilizationMortality
Abstract
Background
Limited data exists regarding healthcare utilization, medical expenses, and prognosis of pulmonary hypertension (PH) according to the World Health Organization (WHO) classification. We aimed to investigate mortality risk, healthcare utilization and medical expenditure in patients with PH across the five diagnostic subgroups.

Methods
We identified 2185 patients with PH, defined as peak tricuspid regurgitation velocity > 3.4 m/sec, among the consecutive patients referred for echocardiography between 2009 and 2015. Using diagnostic codes, medical records, and echocardiographic findings, the enrolled patients were classified according to the five subgroups by WHO classification. Healthcare utilization, costs, and all-cause mortality were assessed.

Results
Diagnostic subgroups of PH demonstrated significantly different clinical features. During a median of 32.4 months (interquartile range, 16.2–57.8), 749 patients (34.3%) died. Mortality risk was the lowest in group II (left heart disease) and highest in group III (chronic lung disease). The etiologies of pulmonary arterial hypertension (PAH) had significant influence on the mortality risk in group I, showing the worst prognosis in PAH associated with connective tissue disease. Medical expenditure and healthcare utilization were different between the PH subgroups: groups II and V had more hospitalizations and medical expenses than other groups. Regardless of PH subgroups, the severity of PH was associated with higher mortality risk, more healthcare utilization and medical expenditure.


Conclusions
Significant differences in clinical features and prognostic profiles between PH subgroups reflect the differences in pathophysiology and clinical consequences. Our findings highlight the importance of comprehensive understanding of PH according to the etiology and its severity.
This study was supported by Seoul National University Bundang Hospital (13–2016-018).
ISSN
1471-2466
Language
English
URI
https://doi.org/10.1186/s12890-019-0945-0

http://hdl.handle.net/10371/164417
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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