Ellis Charles N, Drake Lynn A, Prendergast Mary M, Abramovits William, Boguniewicz Mark, Daniel C Ralph, Lebwohl Mark, Stevens Seth R, Whitaker-Worth Diane L, Cheng J Wang, Tong Kuo B
Department of Dermatology, University of Michigan Medical School, 1500 E Medical Center Drive, Ann Arbor, MI 48109-0314, USA.
J Am Acad Dermatol. 2002 Mar;46(3):361-70. doi: 10.1067/mjd.2002.120528.
Atopic dermatitis/eczema (AD/E) is a common disease. Few studies have attempted to quantify the cost to third-party payers.
Our purpose was to identify the annual cost of medical services and prescription drugs for the treatment of AD/E to private insurance and Medicaid payers in the United States.
We used a retrospective study design employing claims data from 1997 and 1998 from a private insurer and a state Medicaid program to analyze costs incurred. Beneficiaries were considered to have AD/E if they had at least one claim in 1997 with a primary or secondary listing of 1 of 3 diagnosis codes: 691.8, other atopic dermatitis and related conditions; 692.9, contact dermatitis and other eczema when no cause is specified; or 373.3, noninfectious dermatoses of eyelid. Patients who did not meet the diagnosis criteria served as a control group in each payer for comparisons of expenditures with the AD/E group.
Disease prevalence was 2.4% (private insurer) to 2.6% (Medicaid) of all eligible beneficiaries, and 3.5% to 4.1% of patients submitted at least one health care claim during the study period. Medicaid-insured patients used outpatient hospital visits and hospitalizations at a greater rate than did privately insured patients; neither used emergency departments extensively. The third-party payer cost of illness for AD/E ranged from $0.9 billion to $3.8 billion when projected across the total number of persons younger than 65 years insured by private insurers and Medicaid in the United States. More than one fourth of all health care costs for patients with AD/E may be attributed to AD/E and co-morbid conditions.
Annual costs of AD/E are similar to those of other diseases such as emphysema, psoriasis, and epilepsy. Patients incur significant costs associated with AD/E and co-morbid conditions.
特应性皮炎/湿疹(AD/E)是一种常见疾病。很少有研究试图对第三方支付者的成本进行量化。
我们的目的是确定美国私人保险和医疗补助支付者用于治疗AD/E的医疗服务和处方药的年度成本。
我们采用回顾性研究设计,利用来自一家私人保险公司和一个州医疗补助项目1997年和1998年的理赔数据来分析所产生的成本。如果受益人在1997年至少有一次理赔记录,且主要或次要诊断代码为以下3个代码之一,则被视为患有AD/E:691.8,其他特应性皮炎及相关病症;692.9,未指明病因的接触性皮炎和其他湿疹;或373.3,眼睑非感染性皮肤病。不符合诊断标准的患者在每个支付者组中作为对照组,用于与AD/E组进行支出比较。
在所有符合条件的受益人中,疾病患病率在私人保险公司为2.4%,在医疗补助项目为2.6%,在研究期间有3.5%至4.1%的患者至少提交了一次医疗保健理赔申请。参加医疗补助保险的患者门诊就诊和住院的比例高于参加私人保险的患者;两者都没有大量使用急诊科。当推算美国私人保险公司和医疗补助项目承保的65岁以下人群总数时,AD/E的第三方支付者疾病成本在09亿美元至38亿美元之间。AD/E患者所有医疗保健成本的四分之一以上可能归因于AD/E及共病情况。
AD/E的年度成本与肺气肿、银屑病和癫痫等其他疾病相似。患者因AD/E及共病情况产生了巨大成本。