抗病毒治疗的报销计划降低了北京慢性乙型肝炎患者的肝脏

StephenW

J Dig Dis. 2019 Jun 24. doi: 10.1111/1751-2980.12794. [Epub ahead of print]
A reimbursement program of antiviral therapy reduced liver-related mortality in patients with chronic hepatitis B in Beijing.
Li M1, Kong Y1, Wu S1, Zhou J2, Wu X2, Wang L2, Su J3, Ou X2, You H2, Xie X4, Wei Z3, Jia J2.
Author information

1
    Clinical Epidemiology and EBM Unit, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
2
    Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China.
3
    Statistics Center, Beijing Center for Diseases Prevention and Control, Beijing, 100013, China.
4
    National Health and Family Planning Commission of the People's Republic of China, 100044, Beijing, China.

Abstract
OBJECTIVE:

Antiviral hepatitis B therapy has been included in the reimbursement list of medical insurance in Beijing since July 1, 2011. This study aimed to assess the impact of this reimbursement program on liver-related death for patients with Chronic Hepatitis B (CHB).
METHODS:

Profiles of CHB patients discharged between 2008.1 and 2015.12 were retrieved from Hospital Discharge Database of Beijing. Liver-related deaths of these patients occurred between 2008.1 and 2017.12 were retrieved by linking to Death Certification Database. Liver-related mortality (dividing the number of death cases by their observed person-years) before and after launching this reimbursement program were calculated and compared. Poisson regression was performed to assess the strength of association (risk ratio, RR) between this reimbursement program and liver-related mortality.
RESULTS:

Information of 35,943 discharged patients was retrieved, consisting of 17,114 non-cirrhotic and 18,829 compensated cirrhotic CHB patients. There were 3,832 liver-related deaths during 190,695 observed person-years. After launching this reimbursement program, liver-related mortality per 100 person-years dropped from 0.38% to 0.16% for non-cirrhotic CHB patients, and it also declined from 4.03% to 3.39% for compensated cirrhotic CHB patients. This reimbursement program was associated with a lower risk of developing liver-related death for non-cirrhotic (RR=0.40, 95%CI: 0.30-0.52) and compensated cirrhotic CHB patients (RR=0.84, 95%CI: 0.78-0.89).
CONCLUSIONS:

Coverage of antiviral therapy by basic medical insurance reduced the risk of developing liver-related death for non-cirrhotic and compensated cirrhotic CHB patients. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

Chronic hepatitis B; Liver-related death; Reimbursement

PMID:
    31231938
DOI:
    10.1111/1751-2980.12794

StephenW

J Dig Dis。 2019年6月24日doi：10.1111 / 1751-2980.12794。 [印刷前的电子版]
抗病毒治疗的报销计划降低了北京慢性乙型肝炎患者的肝脏相关死亡率。
Li M1，Kong Y1，Wu S1，Zhou J2，Wu X2，Wang L2，Su J3，Ou X2，You H2，Xie X4，Wei Z3，Jia J2。
作者信息

1
首都医科大学附属北京友谊医院消化疾病国家临床研究中心临床流行病学和EBM单位，北京100050
2
首都医科大学附属北京友谊医院肝脏研究中心;北京市肝硬化转化医学重点实验室;国家消化病临床研究中心，北京100050
3
北京市疾病预防控制中心统计中心，北京100013
4
中华人民共和国国家卫生和计划生育委员会，100044，北京，中国。

抽象
目的：

自2011年7月1日起，抗病毒性乙型肝炎治疗已纳入北京医疗保险报销清单。本研究旨在评估此报销计划对慢性乙型肝炎（CHB）患者肝脏相关死亡的影响。
方法：

从北京医院出院数据库中检索出2008.1至2015.12期间出院的CHB患者概况。这些患者的肝脏相关死亡发生在2008.1和2017.12之间，通过链接到死亡认证数据库检索。计算并比较了在启动该报销计划之前和之后与肝脏相关的死亡率（将死亡病例数除以其观察人数 - 年）。进行泊松研究以评估该报销计划与肝脏相关死亡率之间的关联强度（风险比，RR）。
结果：

检索到35,943名出院患者的信息，包括17,114名非肝硬化患者和18,829名代偿性肝硬化CHB患者。在190,695个观察人年中，有3,832例肝脏相关死亡。启动此报销计划后，非肝硬化CHB患者每100人年肝功能相关死亡率从0.38％下降至0.16％，补偿性肝硬化CHB患者也从4.03％下降至3.39％。该报销计划与非肝硬化（RR = 0.40,95％CI：0.30-0.52）和代偿性肝硬化CHB患者发生肝脏相关死亡的风险较低相关（RR = 0.84,95％CI：0.78-0.89） 。
结论：

基本医疗保险的抗病毒治疗覆盖范围降低了非肝硬化和代偿性肝硬化CHB患者发生肝脏相关死亡的风险。本文受版权保护。

本文受版权保护。版权所有。
关键词：

慢性乙型肝炎;肝脏相关死亡;报销

结论：
31231938
DOI：
10.1111 / 1751-2980.12794