Direct health care costs of Crohn's disease and ulcerative colitis in US children and adults.
Direct health care costs of Crohn's disease and ulcerative colitis in US children and adults.
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DOI：
10.1053/j.gastro.2008.09.012
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发表时间：
2008-12
期刊：
影响因子：
29.4
通讯作者：
Finkelstein, Jonathan A.
中科院分区：
文献类型：
--
作者：
Kappelman, Michael D.;Rifas-Shiman, Sheryl L.;Porter, Carol Q.;Ollendorf, Daniel A.;Sandler, Robert S.;Galanko, Joseph A.;Finkelstein, Jonathan A.
关于美国炎症性肠病（IBD）的医疗保健费用的数据有限。1)估计美国克罗恩病（CD）和溃疡性结肠炎（UC）的直接成本。2）描述住院、门诊和药物服务之间的成本分布; 3）确定影响这些成本的社会人口因素。我们从一个行政数据库中提取了医疗和药房索赔，该数据库包含来自33个州的87个健康计划的保险索赔，发生在2003-2004年之间。我们使用管理定义确定了CD和UC病例。对于每种情况，我们选择最多3个非IBD对照。根据现行程序术语或国家药物代码，将索赔分类为住院、门诊或药物。费用是根据每项索赔的已付数额计算的。IBD可归因成本通过从IBD患者中减去非IBD患者的成本来估计。Logistic回归用于确定影响这些成本的社会人口因素。我们确定了9，056名CD患者和10，364名UC患者。CD和UC的平均年成本分别为8265美元和5066美元。对于CD，31%的费用归因于住院，33%归因于门诊护理，35%归因于药物索赔。UC的相应分布分别为38%、35%和27%。与成人相比，20岁以下儿童的费用明显较高，但性别或地区差异不大。这项研究证明了IBD的巨大经济负担，并可用于为卫生政策提供信息。
Data regarding the health care costs of inflammatory bowel disease (IBD) in the United States are limited. 1) To estimate the direct costs of Crohn’s disease (CD) and ulcerative colitis (UC) in the U.S. 2) To describe the distribution of costs between inpatient, outpatient, and pharmaceutical services, and 3) To identify sociodemographic factors influencing these costs. We extracted medical and pharmacy claims from an administrative database containing insurance claims from 87 health plans in 33 states, occurring between the years 2003–2004. We identified cases of CD and UC using an administrative definition. For each case, we selected up to 3 non-IBD controls. Claims were classified as inpatient, outpatient, or pharmaceutical according to Current Procedural Terminology or National Drug Codes. Costs were based on the paid amount of each claim. IBD-attributable costs were estimated by subtracting costs for non-IBD patients from those with IBD. Logistic regression was used to identify the sociodemographic factors affecting these costs. We identified 9,056 CD patients and 10,364 UC patients. Mean annual costs for CD and UC were $8265 and $5066 respectively. For CD, 31% of costs were attributable to hospitalization, 33% to outpatient care, and 35% to pharmaceutical claims. The corresponding distribution for UC was 38%, 35%, and 27% respectively. Costs were significantly higher for children age < 20, compared to adults, but did not vary substantially by gender or region. This study demonstrates a substantial economic burden of IBD and can be used to inform health policy.
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影响因子：
9.7
作者：
Druss, BG;Marcus, SC;Pincus, HA
通讯作者：
Pincus, HA
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29.4
作者：
MCLEOD, RS;CHURCHILL, DN;COHEN, Z
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作者：
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通讯作者：
Markowitz, James
影响因子：
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作者：
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通讯作者：
Washington, Benjamin