Resource use and costs associated with diabetic macular edema in elderly persons.
Resource use and costs associated with diabetic macular edema in elderly persons.
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DOI：
10.1001/archopht.126.12.1748
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发表时间：
2008-12
影响因子：
--
通讯作者：
Schulman, Kevin A.
中科院分区：
文献类型：
--
作者：
Shea, Alisa M.;Curtis, Lesley H.;Hammill, Bradley G.;Kowalski, Jonathan W.;Ravelo, Arliene;Lee, Paul P.;Sloan, Frank A.;Schulman, Kevin A.
研究老年患者资源使用的趋势以及糖尿病黄斑水肿（DME）事件对1年和3年总直接医疗费用的影响。我们使用了2000年至2004年具有全国代表性的5%的医疗保险受益人样本，以确定发生DME的患者和无视网膜疾病史的糖尿病患者对照队列。我们总结了所有索赔的医疗保险报销金额，并应用广义线性模型来估计DME对1年和3年成本的影响。我们还检查了所选成像技术和治疗方法的使用。在调整人口统计学特征和基线共病条件后，DME与31%的1年费用和29%的3年费用增加有关。检测和治疗方式的使用发生了重大变化。从2000年到2004年，玻璃体内注射从1%增加到13%的患者;光学相干断层扫描的使用从2.5%增加到40%以上。激光光凝的使用随着时间的推移而减少。在调整人口统计学变量和基线共病条件后，新发DME是1年和3年总医疗费用的重要独立预测因素。DME的诊断和治疗方式发生了重大变化。
To examine trends in resource use and the impact of incident diabetic macular edema (DME) on 1-year and 3-year total direct medical costs in elderly patients. We used a nationally representative 5% sample of Medicare beneficiaries from 2000 through 2004 to identify patients with incident DME and a control cohort of patients with diabetes mellitus but no history of retinal disease. We summed Medicare reimbursement amounts for all claims and applied generalized linear models to estimate effects of DME on 1-year and 3-year costs. We also examined use of selected imaging techniques and treatments. After adjustment for demographic characteristics and baseline comorbid conditions, DME was associated with 31% higher 1-year costs and 29% higher 3-year costs. There were significant shifts in the use of testing and treatment modalities. From 2000 to 2004, intravitreal injection increased from 1% to 13% of patients; use of optical coherence tomography increased from 2.5% to more than 40%. Use of laser photocoagulation decreased over time. After adjustment for demographic variables and baseline comorbid conditions, new-onset DME was a significant independent predictor of total medical costs at 1 and 3 years. Diagnostic and treatment modalities used for DME have changed significantly.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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