Median arcuate ligament syndrome: a cost analysis to determine the economic burden of a rarely diagnosed disease.
Median arcuate ligament syndrome: a cost analysis to determine the economic burden of a rarely diagnosed disease.
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DOI：
10.3389/fpsyg.2023.1166744
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发表时间：
2023
影响因子：
3.8
通讯作者：
Drossos, Tina
中科院分区：
文献类型：
--
作者：
Skelly, Christopher L.;Stiles-Shields, Colleen;Goldenthal, Hayley;Bohr, Nicole;Feldman, Estee;Mak, Grace Zee;Drossos, Tina
关键词：
慢性腹痛 (CAP) 是一种导致巨大经济负担和医疗保健利用成本的疾病。 CAP 的一个尚未得到研究的来源是正中弓状韧带综合征 (MALS)。 MALS 通常由于多种原因而未被诊断和治疗，包括 MALS 与类似于 CAP 的心理症状和精神疾病高度共存。为了更好地为未来的 MALS 研究工作提供信息，我们进行了一项试点研究，以估计这种情况的经济影响和公共卫生负担。我们假设 MALS 会造成重大的公共卫生负担。参加一项前瞻性研究的儿科和成人患者在三级医疗机构接受 MALS 的多学科评估和治疗，被邀请参加一项简短的自我报告调查，即 MALS 的直接和间接医疗影响表，以获取医疗保健资源，包括手术、手术、医疗保健就诊和缺勤（学校和工作）。为了根据 MALS 表的直接和间接医疗保健影响估算成本，利用 FSC-93 计费数据以及手术前一年和手术后的手术和提供者就诊的相应当前程序术语 (CPT) 代码，将患者自行报告的医疗保健使用数据转换为美元价值。我们进行了描述性分析，以根据人口统计数据和报告的缺勤情况来描述样本的特征。 119 名患者（平均年龄 = 30.9 ± 13.0）完成了问卷调查，回复率为 57%。 82.4% (n = 98) 的参与者是女性，90.8% (n = 108) 是非西班牙裔/拉丁裔白人。平均和中位手术随访时间分别为 5.3 年和 5.4 年。总体而言，每位患者的医疗服务提供者和辅助医疗服务提供者就诊费用中位数为 19,119 美元，包括术前和术后就诊。仅提供商的平均成本为 28,908 美元。 Wilcoxon 符号秩检验表明，术后缺课天数显着低于术前缺课天数（Z = −3.36，p = 0.001）。同样，整个样本术后缺勤的工作日明显少于手术前 (Z = −2.86，p = 0.004)。正中弓状韧带综合征给患者和医疗保健系统带来巨大的经济负担。目前的研究结果虽然反映了同质人群，但越来越多的文献表明医疗保健差异是 MALS 诊断和治疗率低的原因之一。
Chronic abdominal pain (CAP) is a medical condition resulting in enormous economic burden and healthcare utilization costs. One understudied source of CAP is the median arcuate ligament syndrome (MALS). MALS is often not diagnosed and treated for a variety of reasons, including the fact that MALS is highly comorbid with psychological symptoms and psychiatric disorders similar to CAP. To better inform future work on the study of MALS, we undertook a pilot study to estimate the economic impact and public health burden of this condition. We hypothesized that MALS imposes a significant public health burden. Pediatric and adult patients enrolled in a prospective study undergoing multidisciplinary evaluation and treatment for MALS at a tertiary care facility were invited to participate in a brief self-report survey, the Direct and Indirect Medical Care Impact of MALS Form, to capture health care resources including procedures, surgeries, health care visits, and absenteeism (school and work). To estimate costs from the Direct and Indirect Medical Care Impact of MALS Form, the medical care usage data self-reported by patients were converted to dollar value utilizing FSC-93 billing data and corresponding current procedural terminology (CPT) codes for procedures and provider visits one year prior to surgery and then following surgery. Descriptive analyses were conducted to characterize the sample in terms of demographics and reported absences from school and work. One hundred and nineteen patients (mean age = 30.9 ± 13.0) completed the questionnaires, yielding a 57% response rate. 82.4% (n = 98) of the participants were female and 90.8% (n = 108) were non-Hispanic/Latine white. The mean and median surgical follow-up periods were 5.3 and 5.4 years, respectively. Overall, median cost of provider and ancillary healthcare provider visits for each patient was (US)$19,119 including the pre-operative and post-operative visits. The mean cost for providers alone was (US)$28,908. Wilcoxon signed-ranks tests indicated that the postoperative missed number of days of school were significantly lower than the pre-surgical number of missed school days (Z = −3.36, p = 0.001). Similarly, there were significantly less missed work-days following surgery than before for the entire sample (Z = −2.86, p = 0.004). Median arcuate ligament syndrome imposes a large economic burden on patients and the healthcare system. The current findings, although reflective of a homogenous population, are adding to a growing body of literature suggesting that healthcare disparities play a role in the low rates of diagnosis and treatment of MALS.
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影响因子：
4.3
作者：
Patel, Mikin V.;Dalag, Leonard;Lorenz, Jonathan
通讯作者：
Lorenz, Jonathan
DOI：
10.1007/978-3-319-33293-2_22
发表时间：
2017-01-01
期刊：
DIFFICULT DECISIONS IN VASCULAR SURGERY: AN EVIDENCE-BASED APPROACH
影响因子：
--
作者：
Mak, Grace Zee
通讯作者：
Mak, Grace Zee
影响因子：
3.1
作者：
Gannon, Brenda;Finn, David P.;McGuire, Brian E.
通讯作者：
McGuire, Brian E.
影响因子：
8
作者：
Shelby, Grace D.;Shirkey, Kezia C.;Walker, Lynn S.
通讯作者：
Walker, Lynn S.
影响因子：
4.2
作者：
Mossey, Jana M.
通讯作者：
Mossey, Jana M.