Zhao S Z, Wong J M, Arguelles L M
G.D. Searle & Co., Skokie, Illinois 60077, USA.
Clin Ther. 1999 Mar;21(3):563-75. doi: 10.1016/S0149-2918(00)88309-5.
The objective of this study was to determine the prevalence and cost of leiomyoma-related hospitalizations based on the Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP-3). Data for 1991 and 1992 were obtained from the HCUP-NIS database, which includes an approximate 20% sample of US hospital discharges. ICD-9 (International Classification of Diseases, Ninth Revision) codes 218.0-218.2 and 218.9 were used to identify women between the ages of 15 and 64 years with the diagnosis of leiomyoma. The distribution of leiomyoma was described using demographic characteristics, admission type, length of stay (LOS), mean total charge, specific leiomyoma diagnosis, principal procedure, and other diagnosed diseases. Among hospital admissions of women between the ages of 15 and 64 years during 1991 and 1992, 26 to 28 admissions per 1000 included a diagnosis of leiomyoma. The highest rates of leiomyoma diagnosis were seen in women aged >40 years (65% and 70% for 1991 and 1992, respectively) and black women (26% and 27%, respectively). Approximately 90% of hospitalizations for leiomyoma were routine admissions, with the most common specific diagnosis being intramural leiomyoma of the uterus. In 1992, patients with leiomyoma as the first diagnosis (vs other diagnoses) had significantly lower mean LOS (3.1 vs. 4.4 days; P<0.001) and mean total charge ($5919 vs. $6810; P<0.001). Total abdominal hysterectomy was performed on three quarters of the women admitted for leiomyoma, and these patients had longer mean LOS and higher total charges than those undergoing other procedures. Although not as costly as other conditions, this common disorder among women of reproductive years requires expensive treatment and is a major burden on the health care system.
本研究的目的是根据医疗成本和利用项目(HCUP - 3)的全国住院患者样本(NIS)来确定平滑肌瘤相关住院治疗的患病率和成本。1991年和1992年的数据来自HCUP - NIS数据库,该数据库包含约20%的美国医院出院病例样本。使用国际疾病分类第九版(ICD - 9)编码218.0 - 218.2和218.9来识别年龄在15至�4岁之间诊断为平滑肌瘤的女性。通过人口统计学特征、入院类型、住院时间(LOS)、平均总费用、特定平滑肌瘤诊断、主要手术以及其他诊断疾病来描述平滑肌瘤的分布情况。在1991年和1992年15至�4岁女性的住院病例中,每1000例中有26至28例诊断为平滑肌瘤。平滑肌瘤诊断率最高的是年龄大于40岁的女性(1991年和1992年分别为65%和70%)以及黑人女性(分别为26%和27%)。大约90%的平滑肌瘤住院治疗为常规入院,最常见的特定诊断是子宫肌壁间平滑肌瘤。1992年,以平滑肌瘤作为首要诊断(相对于其他诊断)的患者平均住院时间显著更短(3.1天对4.4天;P<0.001),平均总费用也显著更低(5919美元对6810美元;P<0.001)。四分之三因平滑肌瘤入院的女性接受了全腹子宫切除术,这些患者的平均住院时间更长,总费用也高于接受其他手术的患者。尽管不如其他疾病成本高,但这种育龄期女性的常见疾病需要昂贵的治疗,是医疗保健系统的一项重大负担。