Flare frequency, healthcare resource utilisation and costs among patients with gout in a managed care setting: a retrospective medical claims-based analysis
Flare frequency, healthcare resource utilisation and costs among patients with gout in a managed care setting: a retrospective medical claims-based analysis
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DOI：
10.1136/bmjopen-2014-007214
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发表时间：
2015-01-01
期刊：
影响因子：
2.9
通讯作者：
Choi, Hyon
中科院分区：
文献类型：
--
作者：
Jackson, Robert;Shiozawa, Aki;Choi, Hyon
目的：对于大多数痛风患者来说，极其痛苦的痛风发作是该疾病的主要临床负担。本研究的目的是评估频繁痛风发作与医疗负担的关系，并量化与频繁痛风发作相比，不频繁发作的痛风相关费用和资源使用降低了多少。设计：回顾性队列研究。设置：来自美国大型健康计划的行政索赔数据。参与者：年龄在18岁或以上，并且在2009年1月至2012年4月期间根据医疗和药房索赔有痛风证据的患者有资格入选。在12个月的基线期间评估患者特征。结果测量：在首次符合条件的痛风索赔后的12个月内评估痛风发作频率、医疗费用和资源利用。采用广义线性模型评估发作频率对成本结果的影响，调整后的协变量。结果：102 703例痛风患者符合研究纳入标准; 89 201例有0-1痛风发作，9714例有2发作，3788例有3+发作。与0-1次发作的患者相比，2次或3次以上发作的患者的痛风相关住院、急诊和门诊平均次数更高（所有P
Objectives: For most gout patients, excruciatingly painful gout attacks are the major clinical burden of the disease. The goal of this study was to assess the association of frequent gout flares with healthcare burden, and to quantify how much lower gout-related costs and resource use are for those with infrequent flares compared to frequent gout flares.Design: Retrospective cohort study.Setting: Administrative claims data from a large US health plan.Participants: Patients aged 18 years or above, and with evidence of gout based on medical and pharmacy claims between January 2009 and April 2012 were eligible for inclusion. Patient characteristics were assessed during a 12-month baseline period.Outcome measures: Frequency of gout flares, healthcare costs and resource utilisation were assessed in the 12 months following the first qualifying gout claim. Generalised linear models were employed to assess the impact of flare frequency on cost outcomes after adjusting for covariates.Results: 102 703 patients with gout met study inclusion criteria; 89 201 had 0-1 gout flares, 9714 had 2 flares, and 3788 had 3+ flares. Average counts of gout-related inpatient stays, emergency room visits and ambulatory visits were higher among patients with 2 or 3+ flares, compared to those with 0-1 flares (all p