Evaluation of healthcare costs and utilization for patients with gout: a population-based matched cohort study
Evaluation of healthcare costs and utilization for patients with gout: a population-based matched cohort study
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痛风患者的医疗保健成本和利用率评估：一项基于人群的匹配队列研究
DOI：
10.1080/03007995.2017.1417826
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发表时间：
2018
影响因子：
2.3
通讯作者：
Y. Ko
中科院分区：
文献类型：
--
作者：
Yi;C. Tang;Jin;L. Kuo;Y. Ko
摘要 目的：为了更好地了解台湾痛风患者的经济负担，进行了一项全国性回顾性研究，比较痛风患者和无痛风患者的医疗费用和利用率。方法：使用 2010 年纵向健康保险数据库 (LHID) 来识别痛风病例并匹配无痛风对照。痛风病例被定义为 (1) 至少 3 例根据医疗索赔诊断为痛风，或 (2) 2011 年有 1 例痛风诊断且至少有一项与痛风相关的药房索赔。对照队列按年龄、性别、居住区域和查尔森合并症指数以 3:1 的比例与病例进行匹配。在病例和对照之间比较索引日期后 365 天内的所有医疗利用率和每位患者的费用。结果：在 993,332 名受益人中，共有 21,376 名匹配的痛风患者符合痛风纳入标准。与对照组相比，痛风患者的门诊就诊次数更多（平均值 = 31.2 vs 22.6），住院次数更多（平均值 = 1.7 vs 1.5），急诊就诊次数更多（平均值 = 1.9 vs 1.7）（全部p< .0001），门诊费用也更高（中位数 = 634美元 vs 1.5美元） 404 美元）、住院费用（中位 = 美元 1330 美元 vs 1254 美元）和急诊费用（中位 = 美元 87 美元 vs 89 美元）（全部 p< .05）。结论：痛风患者比无痛风患者的医疗利用率和费用更高。在痛风患者中，全因和痛风相关的使用主要是门诊就诊，而大部分全因和痛风相关的费用是住院治疗。研究结果可能对未来的经济评估和医疗资源分配有用。
Abstract Objectives: To better understand the economic burden of gout patients in Taiwan, a nationwide retrospective study was conducted to compare the healthcare costs and utilization between gout and gout-free patients. Methods: The Longitudinal Health Insurance Database (LHID) 2010 was used to identify gout cases and matched gout-free controls. Gout cases were defined as having (1) at least three instances of diagnoses of gout on medical claims, or (2) one diagnosis of gout with at least one gout-related pharmacy claim in 2011. A control cohort was matched with cases at a 3:1 ratio by age, gender, residential area, and the Charlson Comorbidity Index. All medical utilization and costs per patient within the 365 days following the index date were compared between cases and controls. Results: Out of 993,332 beneficiaries, a total of 21,376 matched gout patients met the gout inclusion criteria. Compared to controls, gout patients had more outpatient visits (mean = 31.2 vs 22.6), inpatient visits (mean = 1.7 vs 1.5), and ER visits (mean = 1.9 vs 1.7) (all p < .0001), as well as more outpatient costs (median = USD $634 vs $404), inpatient costs (median = USD $1330 vs $1254), and ER costs (median = USD $87 vs $89) (all p < .05). Conclusion: Gout patients had higher medical utilization and costs than gout-free patients. In gout patients, all-cause and gout-related utilization were mostly outpatient visits, whereas most of the all-cause and gout-related costs were due to hospitalization. The study findings could be useful for future economic evaluations and healthcare resource allocation.