The prevalence of complications and healthcare costs during pregnancy
The prevalence of complications and healthcare costs during pregnancy
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DOI：
10.3111/13696998.2015.1016229
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发表时间：
2015-01-01
影响因子：
2.4
通讯作者：
Landsman-Blumberg, Pamela
中科院分区：
文献类型：
--
作者：
Law, Amy;McCoy, Mark;Landsman-Blumberg, Pamela
目的：研究美国怀孕的经济负担、妊娠期常见的并发症以及这些并发症带来的增量成本。方法：对2007年1月1日至2011年12月31日期间从Truven Health MarketScan商业索赔和遭遇数据库中识别的医疗和药房索赔，对15-49岁的孕妇进行了一项回顾性的比较队列研究。报告了从第一次与怀孕有关的索赔之日到分娩后3个月的总医疗费用(调整后为2011美元)，并将这些费用与非怀孕妇女的匹配对照进行了比较。对妊娠相关并发症进行分类，并用多因素分析估算与每个并发症相关的增量成本。结果：共有322,141名符合条件的活产妇女参与研究。与匹配的对照组相比，孕妇在产后3个月的平均护理费用高出近13,000美元。共有46.9%的女性至少有一个预先指定的妊娠并发症；最常见的观察到的是胎儿畸形(24.7%)和早产或先兆分娩(16.3%)。多胎妊娠(1.9%)导致的调整后增量成本最高(12,212美元；95%CI=11,298，13,216)；高血压(6,152美元；95%CI=5312,6992)和糖尿病(5081美元；95%CI=4244,5918)也是导致高增量护理成本的并发症。
Objective:To study the economic burden of pregnancy in the US, common complications during pregnancy, and the incremental costs attributable to these complications.Methods:A retrospective comparative cohort study was conducted of pregnant women aged 15-49 years using de-identified medical and pharmacy claims from the Truven Health MarketScan Commercial Claims and Encounters database incurred between January 1, 2007 and December 31, 2011. The total healthcare costs are reported (adjusted to 2011 dollars) from the date of the first pregnancy-related claim through to 3 months post-delivery and these costs were compared to matched controls of nonpregnant women. Pregnancy-related complications were categorized, and the incremental costs associated with each complication were estimated using multivariate analyses.Results:A total of 322,141 eligible women with live births were studied. Compared to matched controls, the average costs of care for pregnant women were nearly $13,000 higher through 3 months post-delivery. A total of 46.9% of women had at least one pre-specified pregnancy complication; the most commonly observed were fetal abnormality (24.7%) and early or threatened labor (16.3%). Multiple gestation (1.9%) resulted in the highest adjusted incremental cost ($12,212; 95% CI = 11,298, 13,216); hypertension ($ 6152; 95% CI = 5312, 6992) and diabetes ($ 5081; 95% CI = 4244, 5918) were also among those complications that led to high incremental costs of care.Conclusion:Pregnancy and delivery are frequently compounded by complications that lead to increased costs and resource utilization.