Trends in cost and outcomes among adult and pediatric patients with asthma: 2000-2009
Trends in cost and outcomes among adult and pediatric patients with asthma: 2000-2009
复制标题
DOI：
10.1016/j.anai.2013.09.007
复制
发表时间：
2013-12-01
影响因子：
5.9
通讯作者：
Sullivan, Sean D.
中科院分区：
文献类型：
--
作者：
Jang, Junho;Chan, Kwun Chuen Gary;Sullivan, Sean D.
背景：很少有研究调查了哮喘患者医疗支出和预后的最新趋势。目的：检查成人、青少年和儿童哮喘患者的医疗支出、健康状况和功能结局的水平和变化，并提供2000年至2009年全国哮喘医疗费用的代表性估计。方法：使用2000年至2009年的医疗支出小组调查来估计医疗支出的趋势（根据医疗价格通胀调整），工作日或上学日的损失，和/或修订的12项简短健康调查中的身体部分摘要和精神部分摘要，调整社会人口变量和合并症。结果：成人平均体力成分总结每年下降0.09个单位（95%可信区间0.02 ~ 0.16,P < 0.01），而平均精神成分总结无显著变化。损失的工作日数没有显著变化，每年损失的上学日数略有下降1.8%（95%置信区间为-0.1至3.5,P = 0.06）。青少年的医疗费用平均每年增加2.5%(95%可信区间为0.0 ~ 4.9,P = 0.049)，而成人和儿童的医疗费用平均每年没有显著变化。据估计，2009年美国哮喘的增量医疗支出总额为628亿美元。结论：本研究发现，尽管所有年龄组哮喘患者的医疗费用在10年期间增加或保持稳定，但结果并没有改善。考虑到哮喘的经济负担和过去10年的表现，应继续关注美国的哮喘管理。(C) 2013年美国过敏、哮喘与免疫学学会Elsevier Inc.出版。版权所有。
Background: Few studies have examined recent trends in medical expenditures and outcomes in patients with asthma.Objective: To examine the level and changes in medical expenditures, health status, and functional outcomes in adults, adolescents, and children with asthma and to provide nationally representative estimates of asthma medical costs from 2000 through 2009.Methods: Medical Expenditure Panel Surveys from 2000 through 2009 were used to estimate the trends of medical expenditures (adjusted for medical price inflation), number of workdays lost or schooldays lost, and/or the physical component summary and the mental component summary from the revised 12-Item Short-Form Health Survey, adjusting for sociodemographic variables and comorbidities.Results: The averaged physical component summary decreased 0.09 units annually (95% confidence interval 0.02-0.16, P < .01) in adults, but there were no significant changes to the averaged mental component summary. There was no significant change in the number of workdays lost and a marginal decrease of 1.8% per annum in the number of schooldays lost (95% confidence interval -0.1 to 3.5, P = .06). The medical expenditure means increased 2.5% annually in adolescents (95% confidence interval 0.0-4.9, P = .049), but there were no significant changes for adults and children. The total incremental medical expenditures of asthma in the United States were estimated to be $62.8 billion in 2009.Conclusion: This study found that, although medical costs for patients with asthma increased or remained stable across all age groups over a 10-year period, outcomes did not improve. Considering the economic burden of asthma and the previous 10-year performance, continued attention should be focused on asthma management in the United States. (C) 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.