Health care and productivity costs associated with diabetic patients with macrovascular comorbid conditions.
Health care and productivity costs associated with diabetic patients with macrovascular comorbid conditions.
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DOI：
10.2337/dc09-1128
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发表时间：
2009-12
期刊：
影响因子：
16.2
通讯作者：
Wells BJ
中科院分区：
文献类型：
--
作者：
Fu AZ;Qiu Y;Radican L;Wells BJ
为了从社会角度检查和量化大血管合并症 (MVCC) 对美国糖尿病患者医疗保健和生产成本的影响，本研究利用 2004 年和 2006 年医疗支出小组调查 (MEPS) 汇总数据，纳入了具有全国代表性的成人样本（年龄≥18 岁）。医疗保健费用以年度医疗保健支出来衡量。生产力成本是根据 2006 年全国平均小时工资，根据因病/伤而缺勤和额外休息日造成的生产力损失计算得出的。 2004年和2006年的成本数据均调整为2006年美元。鉴于成本数据的严重右偏分布，在控制了年龄、性别、种族、民族、教育、收入、就业状况、吸烟状况、健康保险、糖尿病严重程度和合并症后，使用具有对数链接函数和 γ 方差的广义线性模型来确定 MVCC 与成本之间的关系。应用负二项式模型来分析缺勤日和就寝日的结果。所有统计数据均使用 MEPS 的适当抽样权重进行调整。与没有 MVCC 的糖尿病患者 (n = 3,320) 相比，在控制了社会人口统计学、吸烟、糖尿病的差异后，患有 MVCC 的糖尿病患者 (n = 913) 的年度医疗费用显着更高（5,120 美元，P < 0.001）、更多缺勤天数（13.03 天，P < 0.001）和更多卧床天数（7.60 天，P = 0.025）严重程度和合并症。每名患者每年的边际生产力损失为 2,388 美元。从美国社会的角度来看，糖尿病患者的 MVCC 与医疗保健增加和生产力成本损失相关。
To examine and quantify from the societal perspective the impact of macrovascular comorbid conditions (MVCCs) on health care and productivity costs in diabetic patients in the U.S. With use of the pooled Medical Expenditure Panel Survey (MEPS) 2004 and 2006 data, a nationally representative adult sample (aged ≥18 years) was included in the study. Health care cost was measured by the annual health care expenditure. Productivity cost was calculated from the lost productivity from missed work days and additional bed days due to illness/injury based on the 2006 average national hourly wage. Both 2004 and 2006 cost data were adjusted to 2006 dollars. Given the heavily right-skewed distribution of the cost data, the generalized linear model with log-link function and γ variance was used to identify the relationship between MVCCs and costs after controlling for age, sex, race, ethnicity, education, income, employment status, smoking status, health insurance, diabetes severity, and comorbidities. Negative binomial models were applied to analyze the outcomes of missed work days and bed days. All statistics were adjusted using the proper sampling weight from MEPS. Compared with diabetic patients without MVCCs (n = 3,320), those with MVCCs (n = 913) had statistically significant higher annual health care costs (5,120 USD, P < 0.001), more missed work days (13.03 days, P < 0.001), and more bed days (7.60 days, P = 0.025) per patient after controlling for differences in sociodemographics, smoking, diabetes severity, and comorbidities. The marginal lost productivity cost was 2,388 USD annually per patient. From the U.S. societal perspective, MVCCs in diabetic patients are associated with increased health care and lost productivity costs.
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