Health care costs and their predictors of inflammatory bowel diseases in Germany
Health care costs and their predictors of inflammatory bowel diseases in Germany
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DOI：
10.1007/s10198-010-0281-z
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发表时间：
2011-06-01
影响因子：
4.4
通讯作者：
Mittendorf, Thomas
中科院分区：
文献类型：
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作者：
Prenzler, Anne;Bokemeyer, Bernd;Mittendorf, Thomas
德国炎症性肠病(IBD)的详细成本研究有限。本研究的目的是通过横断面研究收集与IBD相关的资源使用数据，从法定健康保险(SHI)的角度对这些数据进行量化，并确定成本驱动因素。2006年3月至2007年7月，来自24家胃肠病专科诊所和两家医院的克罗恩病(CD)或溃疡性结肠炎(UC)患者登记在互联网数据库中。从SHI的角度记录和评估2007年的门诊服务、住院次数以及用药情况。疾病严重程度分别采用克隆氏病活动性指数(CDAI)和结肠炎活动性指数(CAI)进行评估。进行了广泛的统计分析，包括广义线性建模(带有对数链接的Gamma模型)以确定成本驱动因素。收集了1,030名IBD患者(CD：511；UC：519)的数据。平均而言，一名CD患者的年费用为3767欧元(+/-5895(SD))(其中68.5%是药物治疗；20.5%是住院患者)；UC患者的平均年费用是2478欧元(+/-4591欧元)(74%的药物治疗；10%的住院患者)，而10%的IBD患者占49%(CD：50%；UC：46%)。回归分析显示，尤其是肿瘤坏死因子-α抑制剂的使用、住院天数、性别以及病情严重程度对费用有显著影响。进一步确定了疾病特定的影响因素。这是第一项从德国SHI的角度计算CD和UC的成本并确定成本驱动因素的研究。这证实了IBD给付款人和社会带来了沉重的经济负担。
Detailed cost studies of inflammatory bowel diseases (IBD) for Germany are limited. Aim of this study was to collect resource-use data related to IBD via a cross-sectional study, to quantify these from the perspective of the Statutory Health Insurance (SHI) and to identify cost-driving factors.Patients with Crohn's disease (CD) or ulcerative colitis (UC) from 24 gastroenterological specialists' practices and two hospitals were enrolled in an internet-based database between March 2006 and July 2007. Outpatient services, inpatient visits as well as medication usage were recorded and evaluated from the perspective of the SHI for 2007. Disease severity was measured by the Crohn's Disease Activity Index (CDAI) and the Colitis Activity Index (CAI), respectively. Extensive statistical analyses including generalized linear modeling (gamma model with the log link) to identify cost-driving factors were performed.Data from 1,030 patients with IBD (CD: 511; UC: 519) were collected. On average a patient with CD incurs annual costs of EUR 3,767 (+/- 5,895 (SD)) (among those 68.5% medication; 20.5% inpatient) and an average patient with UC incurs EUR 2,478 (+/- 4,591) (74% medication; 10% inpatient), whereas 10% of the patient with IBD account for 49% (CD: 50%; UC: 46%) of the costs. The regression analysis showed that especially the use of TNF-alpha-inhibitors, inpatient stays, gender as well as the severity status has a significant influence on costs. Further disease-specific impact factors were identified.This is the first study to calculate costs due to CD and UC from the perspective of the SHI in Germany and to identify cost-driving factors. It confirms a high economic burden of IBD to payers and society.