Economic burden of patients with anemia in selected diseases
Economic burden of patients with anemia in selected diseases
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DOI：
10.1111/j.1524-4733.2005.00058.x
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发表时间：
2005-11-01
期刊：
影响因子：
4.5
通讯作者：
Dubois, R
中科院分区：
文献类型：
--
作者：
Ershler, WB;Chen, K;Dubois, R
目的：探讨特定疾病患者贫血对经济的影响。方法：采用回顾性队列设计来估计贫血和非贫血患者的费用差异。该分析使用来自美国人口的行政索赔数据（1999-2001年）来评估直接成本，并使用残疾和生产力数据（1997-2001年）来估计间接成本。诊断为类风湿性关节炎（RA）、炎症性肠病（IBD）、慢性阻塞性肺疾病（COPD）、慢性肾病（CKD）、癌症或充血性心力衰竭（CHF）的成年患者被确定。使用广义线性模型估算费用，调整年龄、性别、合并症和疾病严重程度。疾病严重程度的调整变量基于ICD-9、HCPCS或药房代码。这些费用是针对100万类似人口的。结果：不同疾病的贫血患者比例不同（6.9-26.1%）；CKD人群患病率最高。CKD贫血患者的平均年直接成本最高（78,209美元），其次是瑞士法郎（72,078美元）和癌症（60,447美元）。在对包括严重程度在内的基线特征进行调整后，所有疾病中贫血和非贫血患者之间的直接成本差异减小；CHF患者在贫血和非贫血之间的调整成本差异最大（29,511美元），其次是CKD（20,529美元）和癌症（18,418美元）。未测量的严重程度和编码偏差可能是调整成本差异的一部分原因。结论：贫血可能大大增加保健费用，这在经济上是非常相关的，尽管这些患者可能只占整个贫血人口的十分之一。
Objective: To examine the economic impact of patients with anemia in selected diseases.Methods: A retrospective cohort design was used to estimate the differences in costs between anemic and nonanemic patients. The analysis used administrative claims data (1999-2001) from a US population to assess direct costs and disability and productivity data (1997-2001) to estimate indirect costs. Adult patients with a diagnosis of rheumatoid arthritis (RA), inflammatory bowel disease (IBD), chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), cancer, or congestive heart failure (CHF) were identified. Costs were estimated using a generalized linear model, adjusting for age, sex, comorbidities, and disease severity. The adjustment variables for disease severity were based on ICD-9, HCPCS, or pharmacy codes. These costs were projected to a 1-million-member, similar population.Results: The percentage of anemia patients varied among conditions (6.9-26.1%); the CKD population had the highest prevalence. CKD anemic patients incurred the greatest average annual direct costs ($78,209), followed by CHF ($72,078) and cancer ($60,447). After adjusting for baseline characteristics including severity, the difference in direct costs between anemic and nonanemic patients decreased for all diseases; CHF patients incurred the greatest adjusted cost difference between anemic and nonanemic ($29,511), followed by CKD ($20,529) and cancer ($18,418). Unmeasured severity and coding bias may account for a portion of the differences in the adjusted cost.Conclusion: Anemia may substantially increase health-care costs at a level that is economically very relevant, despite the fact that these patients may comprise only one tenth of the overall anemic population.