Surgical procedures and their cost estimates among women with newly diagnosed endometriosis: a US database study.
Surgical procedures and their cost estimates among women with newly diagnosed endometriosis: a US database study.
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DOI：
10.3111/13696998.2010.549532
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发表时间：
2011-01-01
影响因子：
2.4
通讯作者：
Lamothe, K
中科院分区：
文献类型：
--
作者：
Fuldeore, M;Chwalisz, K;Lamothe, K
目的：本描述性研究评估了新诊断子宫内膜异位症患者的手术率和费用。方法：利用Medstat MarketScan数据库，确定2006-2007年间新诊断的18-45岁商业保险子宫内膜异位症妇女。每位子宫内膜异位症患者根据年龄和居住地区与四名无子宫内膜异位症的女性（人口对照）相匹配。评估诊断后12个月内接受的外科手术。外科手术的费用由保险公司支付。结果：本研究确定了15,891名新诊断的子宫内膜异位症女性和63,564名人群对照。超过65%的子宫内膜异位症患者在最初诊断的一年内接受了子宫内膜异位症相关的手术。最常见的手术是腹腔镜治疗（31.6%），其次是腹部子宫切除术（22.1%）和阴道子宫切除术（6.8%）。手术的患病率和类型因患者年龄而异，包括35岁以下患者的子宫切除术率约为16%，35-45岁患者的子宫切除术率约为37%。诊断性腹腔镜检查的平均费用从4289美元（标准差：3313美元）到腹部子宫切除术的11397美元（标准差：8749美元）不等。局限性：子宫内膜异位症的诊断不能根据医疗记录进行验证，并且在行政索赔数据中没有关于子宫内膜异位症相关症状严重程度的信息。结论：超过65%的患者在被诊断为子宫内膜异位症的1年内进行了子宫内膜异位症相关的手术，包括子宫切除术。与子宫内膜异位症相关的外科手术费用给医疗保健系统带来了巨大的经济负担。
OBJECTIVE: This descriptive study assessed the rate and costs of surgical procedures among newly diagnosed endometriosis patients.METHODS: Utilizing the Medstat MarketScan database, commercially insured women aged 18-45 with endometriosis newly diagnosed during 2006-2007 were identified. Each endometriosis patient was matched to four women without endometriosis (population controls) based on age and region of residence. Surgical procedures received during the 12 months post-diagnosis were assessed. Costs of surgical procedures were the amount paid by the insurance companies.RESULTS: This study identified 15,891 women with newly diagnosed endometriosis and 63,564 population controls. More than 65% of endometriosis patients received an endometriosis-related surgical procedure within 1 year of the initial diagnosis. The most common procedure was therapeutic laparoscopy (31.6%), followed by abdominal hysterectomy (22.1%) and vaginal hysterectomy (6.8%). Prevalence and type of surgery performed varied by patient age, including a hysterectomy rate of approximately 16% in patients younger than 35 and 37% among patients aged 35-45 years. Average costs ranged from $4,289 (standard deviation [SD]: $3,313) for diagnostic laparoscopy to $11,397 (SD: $8,749) for abdominal hysterectomy.LIMITATIONS: Diagnosis of endometriosis cannot be validated against medical records, and information on the severity of endometriosis-related symptoms is not available in administrative claims data.CONCLUSIONS: Over 65% of patients had endometriosis-related surgical procedures, including hysterectomy, within 1 year of being diagnosed with endometriosis. The cost of surgical procedures related to endometriosis places a significant financial burden on the healthcare system.