The direct and indirect costs among U.S. privately insured employees with hypogonadism.
The direct and indirect costs among U.S. privately insured employees with hypogonadism.
复制标题
美国私人保险雇员性腺机能减退症的直接和间接成本。
DOI：
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复制
发表时间：
2012
影响因子：
3.5
通讯作者：
R. Swindle
中科院分区：
文献类型：
--
作者：
A. Kaltenboeck;S. Foster;J. Ivanova;M. Diener;R. Bergman;H. Birnbaum;K. Kinchen;R. Swindle
介绍
虽然以前的研究已经指出，性腺功能减退症（HG）可能会造成显着的经济和生活质量的负担，没有研究评估HG对医疗保健利用和成本在美国的影响。
目的
比较有HG的美国私人保险雇员和没有HG的对照组之间的直接（医疗保健）和间接（伤残假或医疗缺勤）费用。
方法
研究样本包括4，269名男性员工，年龄在35-64岁之间，有≥ 2次HG诊断（国际疾病分类，第九次修订，临床修改：257.2x）或≥ 1次HG诊断和≥ 1次睾酮治疗索赔，2005年1月1日至2009年3月31日，从大型私人保险管理数据库中识别，其中包括医疗、处方药、残疾索赔数据。索引日期是最近一次HG诊断，在此之前（基线期）和之后（研究期）至少连续合格1年。HG的雇员在年龄、地区、有薪与无薪就业状况和指数年与无HG的对照组1：1匹配。
主要观察指标
描述性分析比较了人口统计学特征、合并症、资源利用、直接和间接成本（与2009年美元相比）。采用多变量分析调整基线特征，以估计风险调整后的成本。
结果
HG员工和对照组的平均年龄为51岁。与对照组相比，HG员工的基线合并症发生率较高，包括高脂血症（50.2% vs. 25.3%）、高血压（37.7% vs. 21.1%）、背部/颈部疼痛（32.0% vs. 15.7%）和人类免疫缺陷病毒/获得性免疫缺陷综合征（7.1% vs. 0.3%）（均P < 0.0001）。HG员工的平均研究期间直接成本（10，914美元对3，823美元）和间接成本（3，204美元对1，450美元）较高; HG相关的直接成本为832美元（所有P < 0.0001）。HG员工的风险调整直接成本（9，291美元对5，248美元）和间接成本（2，729美元对1，840美元）也更高（所有P < 0.0001）。
结论
与对照组相比，HG患者的合并症发生率和成本较高。鉴于HG相关成本较低，HG患者成本的主要驱动因素似乎是其合并症负担。
INTRODUCTION
While previous studies have noted that hypogonadism (HG) may pose a significant economic and quality-of-life burden, no studies have evaluated the impact of HG on healthcare utilization and costs in the United States.
AIM
Compare direct (health care) and indirect (disability leave or medical absence) costs between privately insured U.S. employees with HG and controls without HG.
METHODS
The study sample included 4,269 male employees, ages 35-64, with ≥ 2 HG diagnoses (International Classification of Diseases, Ninth Revision, Clinical Modification: 257.2x) or ≥ 1 HG diagnosis and ≥ 1 claim for testosterone therapy, 1/1/2005-3/31/2009, identified from a large, private insurance administrative database that includes medical, prescription drug, and disability claims data. The index date was the most recent HG diagnosis that had continuous eligibility for at least 1 year before (baseline period) and 1 year after (study period). Employees with HG were matched 1:1 on age, region, salaried vs. nonsalaried employment status, and index year to controls without HG.
MAIN OUTCOME MEASURES
Descriptive analyses compared demographic characteristics, comorbidities, resource utilization, direct and indirect costs inflated to USD 2009. Multivariate analyses adjusting for baseline characteristics were used to estimate risk-adjusted costs.
RESULTS
HG employees and controls had a mean age of 51 years. HG employees compared with controls had higher baseline comorbidity rates, including hyperlipidemia (50.2% vs. 25.3%), hypertension (37.7% vs. 21.1%), back/neck pain (32.0% vs. 15.7%), and human immunodeficiency virus/acquired immunodeficiency syndrome (7.1% vs. 0.3%) (all P < 0.0001). HG employees had higher mean study period direct ($10,914 vs. $3,823) and indirect costs ($3,204 vs. $1,450); HG-related direct costs were $832 (all P < 0.0001). Risk-adjusted direct ($9,291 vs. $5,248) and indirect ($2,729 vs. $1,840) costs were also higher for HG employees (all P < 0.0001).
CONCLUSIONS
Employees with HG had higher comorbidity rates and costs compared with controls. Given the low HG-related costs, a primary driver of costs among HG patients appears to be their comorbidity burden.
老年男性的生物可利用睾酮和抑郁情绪：兰乔贝尔纳多研究。
DOI：
10.1210/jcem.84.2.5495
发表时间：
1999
期刊：
The Journal of clinical endocrinology and metabolism.
影响因子：
--
作者：
Barrett-Connor,E;VonMuhlen,DG;Kritz-Silverstein,D
通讯作者：
Kritz-Silverstein,D
影响因子：
7.2
作者：
ROMANO, PS;ROOS, LL;JOLLIS, JG
通讯作者：
JOLLIS, JG