Identification of a pulmonary arterial hypertension (PAH) patient cohort and study of its burden of illness in Programme de Médicalisation des Systèmes d'information (PMSI)

Abstract

ObjectivesDefine a French PAH cohort using an evidence-based algorithm and describe its burden of disease in terms of healthcare resource use and costs. MethodsA retrospective database analysis was performed using the French national hospital discharge database (PMSI-MCO, 2012–2016). The main criteria used to define the PAH patient cohort were the PH ICD-10 codes (I27.0 or I27.2), a visit to an expert referral centre, a right heart catheterisation procedure and/or a prescription of a PAH specific drug. Hospital visits were split based on the length of stay. 0-day length of stay visits were labelled outpatient visits while all others were labelled inpatient visits. ResultsA cohort of 2173 patients diagnosed with PAH was defined. These patients had 26,944 hospital visits over the study period. Approximately 63% of patients were female and mean age at index date was 58 years old. Inpatient visits represented 52% of total hospital events with an average between 2.2 and 2.3 inpatient visits per year per patient. The average number of outpatient visits per year increased from 1.4 to 2.5 (2012 to 2016). The average cost per patient in 2016 for inpatient visits was equal to €10,256 while outpatient visits cost was equal to €1899. The 20% of patients associated with the highest costs accounted for approximately 60% of total costs in each year. ConclusionsThere is a high hospital economic burden of PAH in France. The high level of resource use and costs is mainly attributable to inpatient visits and has remained stable throughout the time period studied.