Economic Burden of COPD in the Presence of Comorbidities.
Economic Burden of COPD in the Presence of Comorbidities.
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作者：
Mannino DM;Higuchi K;Yu TC;Zhou H;Li Y;Tian H;Suh K
与COPD相关的发病率和死亡率造成相当大的经济负担。COPD合并症与不良健康结局和费用增加相关。我们的目的是评估合并症对COPD相关费用的影响，在一个大型的行政索赔数据集。这是一项回顾性观察性研究，数据来自Truven Health MarketScan商业索赔和遭遇以及MarketScan Medicare补充数据库，时间为2009年1月1日至2012年9月30日。测量从索引日期（首次发生非排除COPD诊断的日期）至索引日期后360天的资源消耗。评估了资源使用（全因和疾病特异性[即COPD或哮喘相关]艾德访视、住院、门诊访视、其他门诊访视和总住院时间）和医疗保健成本（艾德访视、住院、门诊访视和其他门诊访视的全因和疾病特异性成本以及医疗、处方和总医疗保健成本）。采用广义线性模型评估合并症对总医疗费用的影响，调整年龄、性别、地理位置、基线医疗使用、就业状况和COPD指标药物。在183，681例COPD患者中，最常见的合并症为心血管疾病（34.8%）、糖尿病（22.8%）、哮喘（14.7%）和贫血（14.2%）。大多数患者（52.8%）有一种或两种关注的合并症。从指数日期到指数日期后360天的平均全因总医疗保健费用最高的是慢性肾病患者（41，288美元）和贫血患者（38，870美元）。贫血对总医疗费用的影响最大（平均比没有贫血的COPD患者多10，762美元）。我们的分析表明，高资源使用和成本与COPD和多种合并症相关。
The morbidity and mortality associated with COPD exacts a considerable economic burden. Comorbidities in COPD are associated with poor health outcomes and increased costs. Our objective was to assess the impact of comorbidities on COPD-associated costs in a large administrative claims dataset. This was a retrospective observational study of data from the Truven Health MarketScan Commercial Claims and Encounters and the MarketScan Medicare Supplemental Databases from January 1, 2009, to September 30, 2012. Resource consumption was measured from the index date (date of first occurrence of non-rule-out COPD diagnosis) to 360 days after the index date. Resource use (all-cause and disease-specific [ie, COPD- or asthma-related] ED visits, hospitalizations, office visits, other outpatient visits, and total length of hospital stay) and health-care costs (all-cause and disease-specific costs for ED visits, hospitalizations, office visits, and other outpatient visits and medical, prescription, and total health-care costs) were assessed. Generalized linear models were used to evaluate the impact of comorbidities on total health-care costs, adjusting for age, sex, geographic location, baseline health-care use, employment status, and index COPD medication. Among 183,681 patients with COPD, the most common comorbidities were cardiovascular disease (34.8%), diabetes (22.8%), asthma (14.7%), and anemia (14.2%). Most patients (52.8%) had one or two comorbidities of interest. The average all-cause total health-care costs from the index date to 360 days after the index date were highest for patients with chronic kidney disease ($41,288) and anemia ($38,870). The impact on total health-care costs was greatest for anemia ($10,762 more, on average, than a patient with COPD without anemia). Our analysis demonstrated that high resource use and costs were associated with COPD and multiple comorbidities.
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DOI：
10.1513/pats.200404-032ms
发表时间：
2005-01-01
期刊：
Proceedings of the American Thoracic Society
影响因子：
--
作者：
Sin, Don D;Man, S F Paul
通讯作者：
Man, S F Paul
影响因子：
24.3
作者：
Mannino, D. M.;Thorn, D.;Holguin, F.
通讯作者：
Holguin, F.
影响因子：
4.8
作者：
Williams, Richard
通讯作者：
Williams, Richard
影响因子：
6.1
作者：
van Gestel, Yvette R. B. M.;Chonchol, Michel;Poldermans, Don
通讯作者：
Poldermans, Don
影响因子：
9.6
作者：
Ford ES
通讯作者：
Ford ES