The costs of heart failure in Poland from the public payer’s perspective. Polish programme assessing diagnostic procedures, treatment and costs in patients with heart failure in randomly selected outpatient clinics and hospitals at different levels of car

Czech, Marcin; Opolski, Grzegorz; Zdrojewski, Tomasz; Dubiel, Jacek S.; Wizner, Barbara; Bolisega, D.; Fedyk-Łukasik, Małgorzata; Grodzicki, Tomasz

doi:10.5603/kp.2013.0032

Cited by 50 publications

(54 citation statements)

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“…Currently, the annual costs of HF treatment are estimated at 3.7% of the NHF budget, and they are expected to double within the next 20 years. Polish data have shown that medication costs constitute less than 5% of the money spent on the treatment of HF, while 79% is related to the hospitalisation [6]. Therefore, effective therapy of HF and limiting the number of hospitalisations among patients with HF seems mandatory.…”

Section: Introductionmentioning

confidence: 99%

Quality of care of hospitalised patients with heart failure in Poland in 2013: results of the second nationwide survey

et al. 2017

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A b s t r a c tBackground: Optimal management of heart failure (HF) patients is crucial to reduce both mortality and the number of hospital admissions, at the same time improving patients' quality of life. Aim:The aim of the study was to assess the quality of care of hospitalised patients with HF in Poland in 2013 and compare it with the results of a similar survey performed in 2005. Methods:The presented study was conducted from April to November 2013 in a sample of 260 hospital wards in Poland, recruited by stratified proportional sampling. Similarly to the first study edition in 2005, a trained nurse contacted physicians, who filled out the study questionnaires on the last five patients with HF, who had been discharged from an internal or cardiological ward. HF did not have to be a major cause of hospital admission. Results:The mean age of the 1300 hospitalised patients was 72.1 years, an increase of 2.3 years since the 2005 survey. The proportion of patients classified as New York Heart Association IV decreased from 28.5% in 2005 to 22.1% in 2013. In comparison with 2005, more patients had concomitant disorders such as hypertension (79.5% vs. 71.0%), diabetes (46.2% vs. 33.2%), and chronic renal failure (33.4% vs. 19.4%). Access to echocardiography has improved in recent years: it was available for 98.9% of the surveyed hospital wards (93% in 2005) and it was performed during the hospitalisation in 60.2% of the patients (58.8% in 2005). In 2013 N-terminal pro-B-type natriuretic peptide was accessible for 80.8% of hospital wards (12.8% in 2005) and the test was performed in 31.3% of the hospitalised patients (3.3% in 2005). Angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB) were administered in 68.9% of HF discharged patients, beta-blockers in 84.8%, mineralocorticoid receptor antagonist (MRA) in 57.9%, diuretics in 85.9%, and digoxin in 23%. The respective numbers in 2005 were 85.9%, 76.0%, 65.4%, 88.9%, and 38.4%. The decrease in prescription of ACEI or ARB resulted from lesser usage of these drugs in internal medicine wards (from 84.3% in 2005 to 55.6% in 2013). Conclusions:In comparison to the analogous project run in 2005, an improvement in some areas of HF treatment was observed in Polish hospitals, such as accessibility to echocardiography and natriuretic peptide measurement as well as beta-blocker and MRA use. At the same time, a meaningful decrease in ACEIs or ARBs usage in internal wards was observed, which might be the result of the ageing of the HF population and an increased number of comorbidities.

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Section: Introductionmentioning

confidence: 99%

Quality of care of hospitalised patients with heart failure in Poland in 2013: results of the second nationwide survey

et al. 2017

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“…It manifests itself as increased plasmatic concentrations of natriuretic peptides, which have diagnostic and prognostic properties in CHF. The essential natriuretic peptide, with a recognised role in both diagnosis and treatment monitoring of CHF patients, is the plasmatic concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP) [5,7,8,[13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Plasmatic NT-proBNP concentrations in patients with coexistent periodontal disease and congestive heart failure: pilot studies

et al. 2017

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A b s t r a c tBackground: The presented pilot study was conducted in order to evaluate dynamic fluctuations of blood inflammation markers among patients with congestive heart failure (CHF) and coexistent periodontitis (PD). Aim:The study hypothesis stated that elimination of chronic inflammation caused by PD has a significant impact on inflammation markers and, secondarily, also on the course and prognosis of CHF. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and tumour necrosis factor alpha (TNF-a) markers were assessed due to their proven diagnostic significance.Methods: Blood samples were collected at the time of CHF patients' admission to the clinical ward (I examination) and then after 3-9 months (average six months) after periodontal treatment completion (II examination). With antibiotic cover, basic periodontal parameters (such as CAL, PD, PI, BOP) were evaluated, scaling and root-planning were performed, and orthopantomogram X-rays were conducted. Patients received instructions about domestic oral hygiene procedures. Measurements were repeated during a second examination of blood samples. Obtained results were compared and statistically analysed. Results:The initial outcome of the study confirmed the hypothesis that maintaining good and complex oral hygiene has an essential impact on blood concentration of NT-proBNP and TNF-a markers.Conclusions: Exploration of possibilities considering medical help and treatment optimisation seems to be evident also according to improvement of prognosis, therapy effectiveness, and patient comfort. Foregoing conclusions about biomarkers are, according to authors' best knowledge, the first such results reported in medical literature.

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“…Na podstawie wyników polskiej części rejestru HF Europejskiego Towarzystwa Kardiologicznego (ESC, European Society of Cardiology) roczna śmiertelność pacjentów hospitalizowanych z powodu HF wynosi blisko 11%, natomiast ryzyko zgonu lub powtórnej hospitalizacji z powodu HF w ciągu rocznej obserwacjiponad 55% [3]. Przekłada się to również na bardzo wysokie koszty opieki zdrowotnej [4,5]. Według analizy z 2012 roku Narodowy Fundusz Zdrowia (NFZ) sfinansował świadczenia zdrowotne w HF w wysokości ponad 672 milinów złotych, w tym większość stanowiły świadczenia szpitalne (94%), a na opiekę ambulatoryjną przeznaczono zaledwie 2% [5].…”

Section: Streszczenieunclassified

Niedokrwistość i niedobór żelaza u chorych z niewydolnością serca — postępowanie diagnostyczne i terapeutyczne

Tymińska

Sypień²,

Ozierański

et al. 2017

Folia Cardiologica

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StreszczeniePrzewlekła niewydolność serca (HF) jest narastającym problemem ochrony zdrowia w krajach wysoko rozwiniętych. W najnowszych wytycznych Europejskiego Towarzystwa Kardiologicznego (ESC) dotyczących postępowania w HF podkreślono potrzebę uwzględnienia czynników ryzyka i chorób towarzyszących, które nasilają objawy HF oraz niekorzystnie wpływają na rokowanie. W ostatnim czasie tematyka licznych badań obejmowała niedokrwistość i niedobór żelaza, które często są obserwowane u pacjentów z HF. Zgodnie z definicją niedokrwistość stwierdza się przy stężeniu hemoglobiny poniżej 13,0 g/dl u mężczyzn i 12,0 g/dl u kobiet. W przebiegu HF wiele czynników może prowadzić do rozwoju niedokrwistości, podczas gdy niedobór żelaza może występować niezależnie od obecności niedokrwistości, a także niezależ-nie pogarszać rokowanie pacjentów z HF. Według wytycznych ESC niedobór żelaza u pacjenta z HF stwierdza się przy stężeniu osoczowej ferrytyny poniżej 100 μg/l lub ferrytyny 100-299 μg/l przy wysyceniu transferryny żelazem poniżej 20%. W niniejszym artykule omówiono częstość i przyczyny występowania niedokrwistości, jej znaczenie prognostyczne, a także postępowanie diagnostyczne oraz możliwości terapeutyczne u pacjentów z HF. Obecnie dostępnych jest kilka form leczenia niedokrwistości. Jednak jedynym leczeniem o udowodnionej efektywności i bezpieczeństwie jest dożylna suplementacja żelaza u objawowych chorych z HF ze zredukowaną frakcją wyrzucania lewej komory przy towarzyszącym niedoborze żelaza.

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The costs of heart failure in Poland from the public payer’s perspective. Polish programme assessing diagnostic procedures, treatment and costs in patients with heart failure in randomly selected outpatient clinics and hospitals at different levels of car

Abstract: The costs of treating heart failure in Poland are high; proper allocation of resources to diagnostic procedures and treatment may contribute to rationalisation of the relevant expenditure.

Cited by 50 publications

References 15 publications

Quality of care of hospitalised patients with heart failure in Poland in 2013: results of the second nationwide survey

Quality of care of hospitalised patients with heart failure in Poland in 2013: results of the second nationwide survey

Plasmatic NT-proBNP concentrations in patients with coexistent periodontal disease and congestive heart failure: pilot studies

Niedokrwistość i niedobór żelaza u chorych z niewydolnością serca — postępowanie diagnostyczne i terapeutyczne

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