Health-related quality of life and future health care utilization for asthma
Health-related quality of life and future health care utilization for asthma
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DOI：
10.1016/s1081-1206(10)61910-2
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发表时间：
2002-07-01
影响因子：
5.9
通讯作者：
Lieu, T
中科院分区：
文献类型：
--
作者：
Eisner, MD;Ackerson, LM;Lieu, T
目的：在一项前瞻性队列研究中，评估健康相关生活质量(HRQL)对成人哮喘患者未来卫生保健利用和费用的纵向影响。方法：采用分层随机抽样的方法，利用计算机利用数据库和筛查调查项目，对3482名成年北方CA Kaiser永久成员哮喘患者进行分层随机抽样。受试者完成了一项邮寄调查，其中包括通用(SF-12)和哮喘特异性HRQL(ITG-哮喘简写电池)的测量。结果：在纵向随访期间，基线哮喘特有的HRQL与哮喘相关急诊科就诊或住院的风险降低相关(每10分分数增量的优势比为0.84；95%可信区间为0.74~0.95)，控制了人口统计学和临床因素。基础HRQL越好，未来全因住院的风险越低(优势比为0.68；95%可信区间为0.60至0.77)。在接下来的一年里，哮喘患者的高质量生活质量得分越高，与哮喘相关的医疗费用就越低(每增加10分，就会减少0.086美元；95%可信区间为-0.11至-0.06)。较好的一般身体HRQL得分与较低的总成本相关(-0.24对数美元；95%CI-0.32至-0.17)。结论：在大量患有哮喘的成人健康维护组织成员中，哮喘特有的HRQL与未来哮喘相关的使用和成本相关。
Background: Although health-related quality of life (HRQL) has been increasingly used as an outcome in asthma, its utility for identifying patients at risk for adverse asthma outcomes has not been established.Objective: In a prospective cohort study, to evaluate the longitudinal impact of HRQL on future health care utilization and cost among adults with asthma, accounting for known risk factors for utilization.Methods: A stratified random sample of 3,482 adult Northern CA Kaiser Permanente members with asthma was selected using computerized utilization databases and a screening survey item. Subjects completed a mail survey that included measures of generic (SF-12) and asthma-specific HRQL (ITG-Asthma Short Form battery). During the 12 months after survey completion, computerized utilization and cost data were ascertained.Results: Better baseline asthma-specific HRQL was associated with a decreased risk of asthma-related emergency department visit or hospitalization during longitudinal followup (odds ratio per 10-point score increment 0.84; 95% confidence interval [CI] 0.74 to 0.95), controlling for demographic and clinical factors. Better baseline generic physical HRQL was associated with a decreased risk of future all-cause hospitalization (odds ratio 0.68; 95% CI 0.60 to 0.77). More favorable asthma-specific HRQL scores were also related to decreased asthma-related health care costs during the ensuing year (-0.086 log-dollars per 10-point score increment; 95% CI -0.11 to -0.06). Better generic physical HRQL scores were associated with lower total costs (-0.24 log-dollars; 95% Cl -0.32 to -0.17).Conclusions: In a large cohort of adult health maintenance organization members with asthma, asthma-specific HRQL was associated with future asthma-related utilization and cost.