Economic burden of sarcoidosis in a commercially-insured population in the United States
Economic burden of sarcoidosis in a commercially-insured population in the United States
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DOI：
10.1080/13696998.2017.1351371
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发表时间：
2017-01-01
影响因子：
2.4
通讯作者：
Wan, George J.
中科院分区：
文献类型：
--
作者：
Rice, J. Bradford;White, Alan;Wan, George J.
背景：结节病是一种多系统炎症性疾病，其特征是受累器官存在非干酪化肉芽肿。结节病患者的生活质量降低，并发多种合并症的风险增加。对于结节病在最初诊断后的直接和间接费用知之甚少。目的：估计美国结节病患者的医疗资源利用率（HCRU）和商业支付款人承担的费用。方法：选择1998年1月1日至2015年3月31日（索引日期）期间首次诊断为结节病的患者，从去识别的私人保险行政索赔数据库中选择。结节病患者被要求在其索引日期前后12个月连续参加健康计划登记。基于基线特征的logistic回归，对结节病患者与非结节病对照组进行倾向评分（1:1）匹配。在指标日期（“结果期”）之后的12个月内，比较匹配组之间的HCRU负担和工作损失（残疾天数和医疗相关缺勤）。结果：符合选择标准的结节病患者共7119例与对照组匹配。总体而言，每个结节病患者的商业付款人每年平均医疗保健费用总额为19,714美元。主要的成本驱动因素是门诊（9050美元，占46%）和住院（6398美元，占32%）。与对照组相比，结节病患者的总医疗费用高出5,190美元（36%）（19,714美元vs 14,524美元）
Background: Sarcoidosis is a multi-system inflammatory disorder characterized by the presence of non-caseating granulomas in involved organs. Patients with sarcoidosis have a reduced quality-of-life and are at an increased risk for several comorbidities. Little is known about the direct and indirect cost of sarcoidosis following the initial diagnosis.Aims: To provide an estimate of the healthcare resource utilization (HCRU) and costs borne by commercial payers for sarcoidosis patients in the US.Methods: Patients with a first diagnosis of sarcoidosis between January 1, 1998 and March 31, 2015 (index date) were selected from a de-identified privately-insured administrative claims database. Sarcoidosis patients were required to have continuous health plan enrollment 12 months prior to and following their index dates. Propensity-score (1:1) matching of sarcoidosis patients with non-sarcoidosis controls was carried out based on a logistic regression of baseline characteristics. Burden of HCRU and work loss (disability days and medically-related absenteeism) were compared between the matched groups over the 12-month period following the index date ("outcome period").Results: A total of 7,119 sarcoidosis patients who met the selection criteria were matched with a control. Overall, commercial payers incurred $19,714 in mean total annual healthcare costs per sarcoidosis patient. The principle cost drivers were outpatient visits ($9,050 2015 USD, 46%) and inpatient admissions ($6,398, 32%). Relative to controls, sarcoidosis patients had $5,190 (36%) higher total healthcare costs ($19,714 vs $14,524; p