Health Care Resource Utilization and Costs for Influenza-like Illness Among Midwestern Health Plan Members
Health Care Resource Utilization and Costs for Influenza-like Illness Among Midwestern Health Plan Members
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DOI：
10.18553/jmcp.2015.21.7.568
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发表时间：
2015-07-01
影响因子：
2.1
通讯作者：
Klepser, Michael E.
中科院分区：
文献类型：
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作者：
Klepser, Donald G.;Corn, Carolyn E.;Klepser, Michael E.
背景技术背景：每年有6%-20%的美国居民感染流感，超过20万人因流感相关并发症住院。2003年，据估计，美国治疗流感的直接医疗费用为104亿美元。目的：（a）评估住院、门诊/门诊和急诊室环境中流感样疾病（ICU）诊断和治疗的现行做法;（B）评估快速流感诊断测试（RIDT）的使用如何影响这些临床环境中患者的医疗保健利用和成本。在这项回顾性队列研究中，使用来自中西部商业健康保险计划的索赔数据确定了与流感相关的医疗保健遭遇的患者。为了选择与本研究相关的声明，确定了诊断、处方和程序的相应流感ICD-9-CM代码、GPI代码和CPT代码，并用于检测ILI声明。为了对这些数据进行成本分析，使用了账单索赔中的允许金额。使用这些数据，中位数成本，平均成本，最低成本，最高成本确定为每一集的护理。中位成本进行了比较，Wilcoxon双样本检验和Kruskal-Wallis检验，P值为0.05，被用作significant.Results水平：超过32%的流感样疾病事件在这项研究中确定涉及经验性抗病毒治疗，无论是治疗（15%）或预防（17.1%），没有伴随的医疗签证。参考有医疗访视的患者发作，有流感RIDT的患者在27.5%的发作中接受抗病毒治疗，而无RIDT的患者在55%的发作中接受抗病毒治疗。Eppressor与医学访问和RIDT有统计学意义（P
BACKGROUND: Each year, 6%-20% of U.S. residents are infected by influenza, and more than 200,000 people are hospitalized due to complications related to influenza. In 2003, it was estimated that the direct medical costs for the treatment of influenza were $10.4 billion in the United States. OBJECTIVES: To (a) assess the current practice associated with the diagnosis and treatment of influenza-like illnesses (ICUs) in inpatient, ambulatory/outpatient, and emergency room settings and (b) evaluate how the use of rapid influenza diagnostic tests (RIDTs)impacts patient health care utilization and cost in these clinical settings.METHODS: For this retrospective cohort study, patients with an influenza related health care encounter were identified using claims data from a midwestern commercial health insurance plan. In order to select the claims relevant to this study, the corresponding influenza ICD-9-CM codes, GPI codes, and CPT codes for the diagnosis, prescriptions, and procedures were identified and used to detect ILI claims. For the cost analysis of these data, the allowed amount in the billing claims was utilized. Using these data, the median cost, mean cost, minimum cost, and maximum cost were determined for each episode of care. The median costs were compared, and Wilcoxon two-sample tests and Kruskal-Wallis tests with P value of 0.05 were used as the level of significance.RESULTS: Over 32% of the influenza-like illness episodes identified in this study involved empiric antiviral therapy as either treatment (15%) or prophylaxis (17.1%) without an accompanying medical visa. Cf patient episodes with medical visit, patients with an RIDT for influenza received antiviral treatment in 27.5% of the episodes compared with 55% of the episodes for patients with no RIDT. Episodes with a medical visit and an RIDT had statistically significant (P