Effects of multiple chronic conditions on health care costs: an analysis based on an advanced tree-based regression model.
Effects of multiple chronic conditions on health care costs: an analysis based on an advanced tree-based regression model.
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DOI：
10.1186/1472-6963-13-219
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发表时间：
2013-06-15
影响因子：
2.8
通讯作者：
MultiCare study group
中科院分区：
文献类型：
--
作者：
König HH;Leicht H;Bickel H;Fuchs A;Gensichen J;Maier W;Mergenthal K;Riedel-Heller S;Schäfer I;Schön G;Weyerer S;Wiese B;Bussche Hv;Scherer M;Eckardt M;MultiCare study group
考虑数据异质性，分析多发病 (MM) 对医疗保健成本的影响。数据来自一项多中心前瞻性队列研究，该研究随机选择了 1,050 名德国 65 至 85 岁的 MM 初级保健患者。 MM 被定义为 29 种慢性疾病中同时出现 ≥ 3 种病症。使用条件推理树（CTREE）算法来检测对住院护理、门诊护理、药物以及正式和非正式护理费用的基本结构和最有影响力的变量。无论合并症的数量和组合如何，都检测到了影响成本的有限因素。帕金森病（PD）和心功能不全（CI）是对总成本影响最大的变量。与未患有这两种疾病的患者相比，PD 预计平均总费用增加 3.5 倍，达到每 6 个月约 11,000 欧元，CI 增加两倍，达到约 6,100 欧元。 PD 的高总费用主要是由于护理费用。住院护理费用受到脑缺血/慢性中风的显着影响，而药物费用与慢性阻塞性肺病、失眠、帕金森病和糖尿病相关。除了护理费用外，社会人口变量对费用没有显着影响。无论同时发生的疾病的组合和数量如何，PD 和 CI 似乎对老年 MM 患者的总医疗费用影响最大，并且只有有限数量的因素显着影响费用。当前对照试验 ISRCTN89818205
To analyze the impact of multimorbidity (MM) on health care costs taking into account data heterogeneity. Data come from a multicenter prospective cohort study of 1,050 randomly selected primary care patients aged 65 to 85 years suffering from MM in Germany. MM was defined as co-occurrence of ≥3 conditions from a list of 29 chronic diseases. A conditional inference tree (CTREE) algorithm was used to detect the underlying structure and most influential variables on costs of inpatient care, outpatient care, medications as well as formal and informal nursing care. Irrespective of the number and combination of co-morbidities, a limited number of factors influential on costs were detected. Parkinson’s disease (PD) and cardiac insufficiency (CI) were the most influential variables for total costs. Compared to patients not suffering from any of the two conditions, PD increases predicted mean total costs 3.5-fold to approximately € 11,000 per 6 months, and CI two-fold to approximately € 6,100. The high total costs of PD are largely due to costs of nursing care. Costs of inpatient care were significantly influenced by cerebral ischemia/chronic stroke, whereas medication costs were associated with COPD, insomnia, PD and Diabetes. Except for costs of nursing care, socio-demographic variables did not significantly influence costs. Irrespective of any combination and number of co-occurring diseases, PD and CI appear to be most influential on total health care costs in elderly patients with MM, and only a limited number of factors significantly influenced cost. Current Controlled Trials ISRCTN89818205
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DOI：
10.1198/106186006x133933
发表时间：
2006-09-01
影响因子：
2.4
作者：
Hothorn, Torsten;Hornik, Kurt;Zeileis, Achim
通讯作者：
Zeileis, Achim
影响因子：
6.7
作者：
Leicht, H.;Heinrich, S.;Koenig, H. -H.
通讯作者：
Koenig, H. -H.
影响因子：
1.1
作者：
Krauth, C;Hessel, F;Schweikert, B
通讯作者：
Schweikert, B
影响因子：
4.4
作者：
Fortin, M;Bravo, G;Lapointe, L
通讯作者：
Lapointe, L
影响因子：
4.5
作者：
Heinrich, Sven;Luppa, Melanie;Koenig, Hans-Helmut
通讯作者：
Koenig, Hans-Helmut