Cost Burden of Chronic Rhinosinusitis: A Claims-Based Study
Cost Burden of Chronic Rhinosinusitis: A Claims-Based Study
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DOI：
10.1177/0194599810391852
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发表时间：
2011-03-01
影响因子：
3.4
通讯作者：
Martinson, Melissa
中科院分区：
文献类型：
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作者：
Bhattacharyya, Neil;Orlandi, Richard R.;Martinson, Melissa
Objective.量化慢性鼻窦炎（CRS）的医疗费用负担和利用。研究设计。历史队列研究。设置。学术医疗中心.分析了2003年至2008年的医疗索赔数据。如果患者至少有2次CRS相关诊断，并且在诊断之间进行了计算机断层扫描或内窥镜检查，则将其定义为患有慢性鼻窦疾病。从支付者的角度（报销）确定CRS的患病率和成本。研究了超过440万例患者，平均3.1年的合格性和至少1例急性鼻窦炎（ARS）或CRS的诊断。在随后的4年中，共有5.5%（95%置信区间[CI]，5.4%-5.6%）的ARS患者被诊断为CRS。在慢性病患者中，12个月后，39%的人仍在使用CRS护理，24个月后，近28%的人仍在使用CRS护理。在鼻内窥镜或放射学确诊的CRS患者中，46.2%接受了鼻内窥镜手术（ESS）。在ESS之前的一年，病人护理费用平均为2449美元（2341 - 2556美元）。ESS手术加上术后45天的清创和药物治疗费用平均为7726美元（7554 - 7898美元）。在术后45天后的一年中，消费量下降了885美元（P < .0001）。在ESS后的第二年，治疗费用又下降了446美元（P <0.0001）。很大一部分CRS患者需要持续多年的鼻窦疾病治疗。鼻窦手术似乎可以减少鼻窦炎相关医疗保健的消费，但与手术相关的成本很高。
Objective. To quantify the cost burden and utilization of health care for chronic rhinosinusitis (CRS).Study Design. Historical cohort study.Setting. Academic medical centers.Methods. Medical claims data from 2003 to 2008 were analyzed. Patients were defined as having chronic sinus disease if they had a minimum of 2 CRS-related diagnoses with either computed tomography scanning or endoscopy performed between diagnoses. The prevalence and costs of CRS from the payer perspective (reimbursements) were determined.Results. More than 4.4 million patients with an average of 3.1 years of eligibility and at least 1 diagnosis of acute rhinosinusitis (ARS) or CRS were studied. A total of 5.5% (95% confidence interval [CI], 5.4%-5.6%) of those with ARS were diagnosed with CRS in the subsequent 4 years. Among patients with chronic disease, after 12 months, 39% were still consuming care for CRS, and after 24 months, nearly 28% were still doing so. Of the CRS patients whose diagnosis was confirmed with endoscopy or radiology, 46.2% underwent endoscopic sinus surgery (ESS). In the year prior to ESS, patient care costs averaged $2449 ($2341-$2556). The ESS procedure plus 45-day postprocedure debridement and medical therapy costs averaged $7726 ($7554-$7898). In the year following the 45-day postprocedure period, consumption dropped by $885 (P < .0001). In the second year following ESS, therapy costs dropped an additional $446 (P < .0001).Conclusions. A significant proportion of CRS patients require ongoing treatment of their sinus disease for years. Sinus surgery appears to reduce consumption of rhinosinusitis-related health care, but costs related to the procedure are significant.