The cost of medical care for patients with cystic fibrosis in a health maintenance organization
The cost of medical care for patients with cystic fibrosis in a health maintenance organization
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DOI：
10.1542/peds.103.6.e72
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发表时间：
1999-06-01
期刊：
影响因子：
8
通讯作者：
Shay, GF
中科院分区：
文献类型：
--
作者：
Lieu, TA;Ray, GT;Shay, GF
背景囊性纤维化（CF）是世界范围内白色个体中最常见的缩短寿命的遗传性疾病。以前对医疗费用的估计是根据专家意见而不是观察到的费用。需要准确的成本估计，以便能够评估新的干预措施和产前遗传筛查的成本效益。评估一家拥有CF中心的健康维护机构为136名患者提供医疗服务的成本。回顾性分析计算机化成本数据库和囊性纤维化基金会年度调查数据。根据第一秒用力呼气量预测值的百分比对疾病的严重程度进行分类。1996年，每年的医疗费用平均为13300元，由轻微疾病的6200元至严重疾病的43300元不等。在总成本中，47%来自住院，18%来自DNA酶（Pulmozyme），12%来自门诊，10%来自门诊抗生素。当观察到的成本被用来估计整个人口的CF患者在美国的医疗保健费用，这些费用估计为3.14亿美元，1996年美元。我们的结论是，CF的医疗费用随严重程度的不同而变化很大，但即使在轻度疾病患者中也是相当大的：这些研究结果强调了需要制定策略，以确保良好的医疗保险覆盖范围和高质量的护理。
Background. Cystic fibrosis (CF) is the most common life-shortening genetic disorder among white individuals worldwide. Previous estimates of the costs of medical care have been based on expert opinion rather than observed costs. Accurate cost estimates are needed to enable evaluation of the cost-effectiveness of new interventions and prenatal genetic screening recommendations.Objective. To evaluate the cost of medical care for patients (N = 136) served by a health maintenance organization with a CF center.Methods. Retrospective analysis of data from computerized cost databases and the Cystic Fibrosis Foundation annual survey. Severity of disease was classified based on the percent predicted forced expiratory volume at I second.Results. The annual cost of medical care in 1996 averaged $13 300 and ranged from $6200 among patients with mild disease to $43 300 among patients with severe disease. Of total costs, 47% were from hospitalization, 18% were from DNase (Pulmozyme), 12% were from clinic visits, and 10% were from outpatient antibiotics. When the observed costs were used to estimate the costs of medical care for the entire population of CF patients in the United States, these costs were estimated to be $314 million per year in 1996 dollars.Conclusions. We conclude that the cost of medical care for CF varies greatly with severity but is substantial even among patients with mild disease: These findings underscore the need for strategies to ensure good health insurance coverage and high quality care for all individuals with this condition.