Impact of chronic hand dermatitis on quality of life, work productivity, activity impairment, and medical costs
Impact of chronic hand dermatitis on quality of life, work productivity, activity impairment, and medical costs
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DOI：
10.1016/j.jaad.2005.11.1053
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发表时间：
2006-03-01
影响因子：
13.8
通讯作者：
Duh, MS
中科院分区：
文献类型：
--
作者：
Fowler, JE;Ghosh, A;Duh, MS
背景：尚未在美国人群中评估慢性手部皮炎 (ChHD) 对患者报告的结果和经济成本的影响。目的。我们试图评估 ChHD 患者与非 ChHD 患者的生活质量、工作效率、活动障碍和医疗保健费用。方法：制定并验证了一份包含 13 项的自我评估问卷来识别 ChHD。 Skindex-29 和工作生产力和活动损伤问卷用于评估 ChHD 的生活质量和工作生产力。该调查随机邮寄给马萨诸塞州管理式医疗组织的 1380 名成员（N = 507，回复率 = 36.74%）。进行单变量和多变量分析以确定 ChHD 对生活质量、工作效率和活动障碍的增量影响。健康保险索赔用于评估医疗费用。结果：患有先心病的患者的生活质量以及工作效率和活动障碍明显低于非先心病患者；然而，缺勤时间没有显着差异。调整显着协变量后，发现 ChHD 导致总医疗费用增加 25%，这意味着每位患者每月增加 70 美元的费用。 局限性：调查回复率不高；调查受访者可能不能完全代表非受访者。由于忽略了非处方药和间接成本，ChHD 的成本负担被低估。低 R-2 统计表明多变量模型的拟合优度较低。结论：ChHD 对生活质量、工作效率、活动障碍和医疗保健费用具有显着的不利影响。需要更多地认识和治疗这种情况，以改善患者的治疗结果并降低医疗保健成本。
Background: The impact of chronic hand dermatitis (ChHD) on patient-reported outcomes and economic costs has not been assessed in a US population.Objective. We sought to evaluate the quality of life, work productivity, activity impairment, and health care costs of patients with ChHD versus those without ChHD.Methods: A 13-item self-assessment questionnaire to identify ChHD was developed and validated. Skindex-29 and Work Productivity and Activity Impairment questionnaires were used to assess quality of life and work productivity for ChHD. The survey was mailed to a random sample of 1380 members of a Massachusetts managed care organization (N = 507, response rate = 36.74%). Univariate and multivariate analyses were conducted to determine the incremental effect of ChHD on quality of life, work productivity, and activity impairment. Health insurance claims were used to assess medical costs.Results: Quality of life, along with work productivity and activity impairment, were significantly worse for patients with CHD than for those without ChHD; however, there was no significant difference in work time missed. After adjusting for significant covariates, a 25% cost increase in total medical costs was found attributable to ChHD, which translates to an incremental cost of $70 per patient per month.Limitations: Survey response rate is not high; the survey respondents may not be completely representative of the nonrespondents. The cost burden of ChHD is underestimated because of the omission of over-the-counter drug and indirect costs. The multivariate models had a low goodness of fit indicated by the low R-2 Statistics.Conclusions: ChHD has a significant detrimental effect on quality of life, work productivity, activity impairment, and heath care costs. More awareness and treatment of this condition are needed to improve patient outcomes and decrease health care cost.