Chrischilles Elizabeth A, Klepser Donald G, Brooks John M, Voelker Margaret D, Chen-Hardee Shari S, Scott Shane D, Link Brian K, Delgado David J
Health Effectiveness Research Center, College of Public Health, University of Iowa, Iowa City, 52242, USA.
Pharmacotherapy. 2005 May;25(5):668-75. doi: 10.1592/phco.25.5.668.63586.
To estimate the costs of hospitalization for neutropenia among chemotherapy-treated patients with newly diagnosed non-Hodgkin's lymphoma and to assess baseline patient factors associated with these costs.
Retrospective cohort study.
Linked Surveillance, Epidemiology, and End Results Program-Healthcare Cost and Utilization Project databases for Iowa from 1993-1998.
Patients with newly diagnosed non-Hodgkin's lymphoma who received all inpatient care at Iowa hospitals during their first course of chemotherapy.
Neutropenia-related hospitalization costs were estimated from discharge abstracts found within the earliest of the following: 6 months after the diagnosis month, the date of bone marrow transplantation, or date of death. We performed univariate tests of differences in neutropenia-related hospitalization costs in all patients in the sample, as well as tests for neutropenia-related hospitalization costs, length-of-stay, and cost/inpatient day for patients with at least one hospitalization for neutropenia. We modeled total inpatient charges over the period for patients with at least one neutropenia-related hospitalization (multiple regression). A total of 1636 patients with non-Hodgkin's lymphoma had chemotherapy in Iowa and met inclusion criteria; of these, 316 had at least one hospitalization for neutropenia. The 316 patients had 418 stays. Patients with advanced stage (vs limited stage), previous anemia (vs no anemia), positive Charlson comorbidity score (vs score of 0), and diffuse large cell histology (vs follicular) had higher mean neutropenia-related hospitalization cost/patient with non-Hodgkin's lymphoma (p<0.05). Among those with neutropenia-related hospitalizations, a longer length of stay was associated with nonfollicular histologies, previous anemia, and positive Charlson score (p<0.05).
When estimating expected payments for neutropenia-related hospitalization in patients with non-Hodgkin's lymphoma, payers need to be aware of the distribution of clinical characteristics in these patients.
估算新诊断的非霍奇金淋巴瘤化疗患者中性粒细胞减少症的住院费用，并评估与这些费用相关的患者基线因素。
回顾性队列研究。
1993 - 1998年爱荷华州的关联监测、流行病学和最终结果计划 - 医疗保健成本与利用项目数据库。
新诊断的非霍奇金淋巴瘤患者，在其首次化疗期间在爱荷华州医院接受所有住院治疗。
中性粒细胞减少症相关住院费用根据以下最早时间的出院摘要估算：诊断月后6个月、骨髓移植日期或死亡日期。我们对样本中所有患者的中性粒细胞减少症相关住院费用差异进行单变量检验，以及对至少有一次中性粒细胞减少症住院的患者的中性粒细胞减少症相关住院费用、住院时间和每日住院费用进行检验。我们对至少有一次与中性粒细胞减少症相关住院的患者在此期间的总住院费用进行建模（多元回归）。共有1636例非霍奇金淋巴瘤患者在爱荷华州接受化疗并符合纳入标准；其中，316例至少有一次因中性粒细胞减少症住院。这316例患者共住院418次。晚期（与局限期相比）、既往贫血（与无贫血相比）、Charlson合并症评分阳性（与评分为0相比）以及弥漫大细胞组织学（与滤泡性相比）的非霍奇金淋巴瘤患者，其平均中性粒细胞减少症相关住院费用更高（p<0.05）。在有中性粒细胞减少症相关住院的患者中，住院时间较长与非滤泡性组织学、既往贫血和Charlson评分阳性相关（p<0.05）。
在估算非霍奇金淋巴瘤患者中性粒细胞减少症相关住院的预期费用时，支付方需要了解这些患者的临床特征分布情况。
