Cost of post-traumatic stress disorder vs major depressive disorder among patients covered by medicaid or private insurance.
Cost of post-traumatic stress disorder vs major depressive disorder among patients covered by medicaid or private insurance.
复制标题
医疗补助或私人保险覆盖的患者中创伤后应激障碍与重度抑郁症的费用。
DOI：
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发表时间：
2011
影响因子：
3.2
通讯作者：
G. Phillips
中科院分区：
文献类型：
--
作者：
J. Ivanova;H. Birnbaum;Lei Chen;A. Duhig;E. Dayoub;E. Kantor;M. Schiller;G. Phillips
目的
比较医疗补助或私人保险覆盖人群中创伤后应激障碍（PTSD）患者与重度抑郁症（MDD）对照组的医疗费用和资源利用。
研究设计
医疗补助和私人保险行政索赔数据的回顾性分析。
方法
在1999年或之后至少有2个PTSD诊断的患者，以及在2003年或之后至少有1个PTSD诊断的患者，从来自佛罗里达、密苏里州和新泽西（1999-2007）的去识别的医疗补助索赔和私人保险索赔数据库（1999-2008）中确定。患者在索引日期前6个月（基线）和索引日期后12个月（研究期）具有连续资格，年龄为18至64岁。使用类似的选择标准确定了没有PTSD诊断的MDD潜在对照受试者。MDD对照组受试者与PTSD患者在年龄、性别、州或地区、就业状况（仅私人保险）、指数年和种族/民族（仅医疗补助）方面相匹配。研究期间每个患者的利用率和成本，计算为医疗服务和处方药提供者的报销，使用单变量和多变量分析进行比较。
结果
在医疗补助和私人保险人群中，PTSD患者的其他精神健康障碍（如焦虑和双相情感障碍）和精神健康相关资源使用和费用均高于MDD对照组。PTSD患者的平均研究期间总直接医疗费用高于MDD对照组（医疗补助为18，753美元，私人保险为17，990美元，私人保险为10，960美元，P <0.05）。总直接成本的差异是由PTSD患者更高的心理健康相关资源使用造成的。
结论
在医疗补助或私人保险覆盖的患者中，与匹配的对照组MDD患者相比，PTSD患者的平均年人均医疗费用高出4.2%至9.3%。
OBJECTIVE
To compare healthcare costs and resource utilization among patients with post-traumatic stress disorder (PTSD) vs control subjects with major depressive disorder (MDD) in populations covered by Medicaid or private insurance.
STUDY DESIGN
Retrospective analysis of Medicaid and private insurance administrative claims data.
METHODS
Patients with at least 2 PTSD diagnoses during or after 1999, and at least 1 PTSD diagnosis during or after 2003, were identified from deidentified Medicaid claims from Florida, Missouri, and New Jersey (1999-2007) and from a privately insured claims database (1999-2008). Patients had continuous eligibility 6 months before (baseline) and 12 months after (study period) the index date and were aged 18 to 64 years. Potential control subjects having MDD without PTSD diagnosis were identified using similar selection criteria. Control subjects with MDD were matched to patients with PTSD on age, sex, state or region, employment status (private insurance only), index year, and race/ethnicity (Medicaid only). Study period per-patient utilization and costs, calculated as reimbursements to providers for medical services and prescription drugs, were compared using univariate and multivariate analyses.
RESULTS
Patients with PTSD had higher rates of other mental health disorders (eg, anxiety and bipolar disorder) and higher mental health-related resource use and costs than control subjects with MDD in both Medicaid and privately insured populations. The mean study period total direct healthcare costs were higher for patients with PTSD than for control subjects with MDD ($18,753 vs $17,990 for Medicaid and $10,960 vs $10,024 for private insurance, P <.05 for both). The difference in total direct costs was driven by higher mental health-related resource use for patients with PTSD.
CONCLUSION
Patients having PTSD had 4.2% to 9.3% higher mean annual per-patient healthcare costs compared with matched control subjects having MDD among patients covered by Medicaid or private insurance.
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影响因子：
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作者：
Kessler, RC;Chiu, WT;Walters, EE
通讯作者：
Walters, EE
影响因子：
7.2
作者：
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通讯作者：
JOLLIS, JG
影响因子：
7.6
作者：
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通讯作者：
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影响因子：
120.7
作者：
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通讯作者：
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