Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertension
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...
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doaj-505b2731084343dfa212790e9eb1a1c82020-11-25T04:00:58ZengBMCBMC Pulmonary Medicine1471-24662019-10-0119111110.1186/s12890-019-0945-0Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertensionIn-Chang Hwang0Goo-Yeong Cho1Hong-Mi Choi2Yeonyee E. Yoon3Jin Joo Park4Jun-Bean Park5Seung-Pyo Lee6Hyung-Kwan Kim7Yong-Jin Kim8Dae-Won Sohn9Department of Cardiology, Cardiovascular Center, Seoul National University Bundang HospitalDepartment of Cardiology, Cardiovascular Center, Seoul National University Bundang HospitalDivision of Cardiology, Hallym Sacred Heart Hospital, Hallym University College of MedicineDepartment of Cardiology, Cardiovascular Center, Seoul National University Bundang HospitalDepartment of Cardiology, Cardiovascular Center, Seoul National University Bundang HospitalDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineAbstract 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.http://link.springer.com/article/10.1186/s12890-019-0945-0Pulmonary hypertensionHealthcare utilizationMortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
In-Chang Hwang Goo-Yeong Cho Hong-Mi Choi Yeonyee E. Yoon Jin Joo Park Jun-Bean Park Seung-Pyo Lee Hyung-Kwan Kim Yong-Jin Kim Dae-Won Sohn |
spellingShingle |
In-Chang Hwang Goo-Yeong Cho Hong-Mi Choi Yeonyee E. Yoon Jin Joo Park Jun-Bean Park Seung-Pyo Lee Hyung-Kwan Kim Yong-Jin Kim Dae-Won Sohn Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertension BMC Pulmonary Medicine Pulmonary hypertension Healthcare utilization Mortality |
author_facet |
In-Chang Hwang Goo-Yeong Cho Hong-Mi Choi Yeonyee E. Yoon Jin Joo Park Jun-Bean Park Seung-Pyo Lee Hyung-Kwan Kim Yong-Jin Kim Dae-Won Sohn |
author_sort |
In-Chang Hwang |
title |
Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertension |
title_short |
Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertension |
title_full |
Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertension |
title_fullStr |
Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertension |
title_full_unstemmed |
Healthcare utilization, medical expenditure, and mortality in Korean patients with pulmonary hypertension |
title_sort |
healthcare utilization, medical expenditure, and mortality in korean patients with pulmonary hypertension |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2019-10-01 |
description |
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. |
topic |
Pulmonary hypertension Healthcare utilization Mortality |
url |
http://link.springer.com/article/10.1186/s12890-019-0945-0 |
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