Health care costs, utilization and patterns of care following Lyme disease.
Health care costs, utilization and patterns of care following Lyme disease.
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DOI：
10.1371/journal.pone.0116767
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Weiner JP
中科院分区：
文献类型：
--
作者：
Adrion ER;Aucott J;Lemke KW;Weiner JP
莱姆病是美国最常见的媒介传播感染。疾病控制中心估计，大约10%到20%的人可能会经历治疗后莱姆病综合征-一系列症状，包括疲劳、肌肉骨骼疼痛和神经认知主诉，在最初的抗生素治疗莱姆病后持续存在。人们对莱姆病或治疗后莱姆病症状(PTLDS)对美国医疗保健成本和利用率的影响知之甚少。1)研究莱姆病对医疗成本和利用的影响，2)了解莱姆病与PTLDS发生的可能性之间的关系，3)了解PTLDS如何影响医疗成本和利用。这项研究利用了2006年至2010年间在美国参加商业健康保险计划的0-年龄段人士的医疗索赔和会员登记的回顾数据。52,795名接受莱姆病治疗的患者与263,975名没有莱姆病暴露证据的匹配对照组进行了比较。在12个月的时间里，莱姆病的总医疗费用(95%CI：2,807-3,128，p<；.001)和门诊就诊次数(95%CI：86%-%，p<；.001)增加了2,968美元，与对照组(95%CI：4.67-4.87，p<；.001)相比，莱姆病与PTLDS相关诊断的几率增加了4.77倍。在莱姆病患者中，与没有PTLDS相关诊断的患者相比，有一种或多种PTLDS相关诊断的患者在12个月期间的总医疗费用(95%CI：3,542-4,055，P<；001)和门诊就诊次数(95%CI：%-69%，P<；.001)增加了3,798美元。莱姆病与费用的增加有关，超出了容易治疗感染的预期。治疗后出现与PTLDS相关的诊断与巨大的医疗费用和利用率有关。
Lyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome – a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States. 1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization. This study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure. Lyme disease is associated with $2,968 higher total health care costs (95% CI: 2,807-3,128, p<.001) and 87% more outpatient visits (95% CI: 86%-89%, p<.001) over a 12-month period, and is associated with 4.77 times greater odds of having any PTLDS-related diagnosis, as compared to controls (95% CI: 4.67-4.87, p<.001). Among those with Lyme disease, having one or more PTLDS-related diagnosis is associated with $3,798 higher total health care costs (95% CI: 3,542-4,055, p<.001) and 66% more outpatient visits (95% CI: 64%-69%, p<.001) over a 12-month period, relative to those with no PTLDS-related diagnoses. Lyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization.
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DOI：
10.1093/cid/ciu397
发表时间：
2014-09-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Hinckley AF;Connally NP;Meek JI;Johnson BJ;Kemperman MM;Feldman KA;White JL;Mead PS
通讯作者：
Mead PS
影响因子：
14.2
作者：
Henningsson, A. J.;Malmvall, B. -E.;Forsberg, P.
通讯作者：
Forsberg, P.
影响因子：
3.5
作者：
Aucott, John N.;Rebman, Alison W.;Crowder, Lauren A.;Kortte, Kathleen B.
通讯作者：
Kortte, Kathleen B.
影响因子：
168.9
作者：
Stanek, Gerold;Wormser, Gary P.;Strle, Franc
通讯作者：
Strle, Franc
影响因子：
--
作者：
Mueller, I.;Freitag, M. H.;Hunfeld, K. -P.
通讯作者：
Hunfeld, K. -P.