Fenter Thomas C, Naslund Michael James, Shah Manan B, Eaddy Michael T, Black Libby
Applied Health Outcomes, 4114 Woodlands Parkway, Suite 500, Palm Harbor, FL 34685, USA.
Am J Manag Care. 2006 Mar;12(4 Suppl):S90-8.
Costs of treating the 10 most prevalent diagnosed diseases in men > or = 50 years of age were examined in hopes of identifying areas for better medical management and opportunities to decrease healthcare costs.
A retrospective analysis of a large national managed care database was utilized to assess the costs of treating the 10 most diagnosed diseases in aging men. All men initiating pharmacy treatment between July 1, 1997, and January 31, 2003, for (1) hypertension; (2) coronary artery disease (CAD); (3) type 2 diabetes; (4) enlarged prostate; (5) osteoarthritis; (6) gastroesophageal reflux disease; (7) bursitis; (8) arrhythmias; (9) cataracts; and (10) depression were included. Patients were continuously followed 6 months before and 12 months after initiating treatment. Costs of treatment and likelihood of experiencing a significant event were examined.
One-year total disease-specific medical costs were highest for arrhythmias, osteoarthritis, cataracts, and CAD. Total medical costs for bursitis, type 2 diabetes, and enlarged prostate were between $400 and $500. Inpatient costs as a percentage of total medical costs were highest for CAD (75%), osteoarthritis (61%), arrhythmias (57%), and enlarged prostate (40%). For most diseases, pharmacy charges were <50% of the total cost. The likelihood of experiencing a significant clinical event within 1 year of initiating treatment was highest in men with bursitis (23%, surgery) and enlarged prostate (19.2%, acute urinary retention and/or surgery), hypertension (13.5%), and diabetes (9.5%).
The most costly conditions in the 10 most prevalent diseases in men > or = 50 years of age were typically those that required substantial inpatient care. Conditions such as enlarged prostate, diabetes, and hypertension demonstrated a high likelihood of a clinical event within 1 year of initiating treatment. These conditions are therapeutic areas with the greatest likelihood of improvement, given what is known about the use of appropriate pharmacotherapy and the likelihood of treating to goal. Proactive patient management (eg, initiating/maximizing pharmacotherapy) may have the potential to positively impact clinical and economic outcomes for aging men.
对50岁及以上男性中10种最常见确诊疾病的治疗费用进行研究，以期确定可改善医疗管理的领域以及降低医疗成本的机会。
利用一个大型国家管理式医疗数据库进行回顾性分析，以评估老年男性中10种最常被诊断疾病的治疗费用。纳入1997年7月1日至2003年1月31日期间开始接受药物治疗的所有男性，所患疾病包括：（1）高血压；（2）冠状动脉疾病（CAD）；（3）2型糖尿病；（4）前列腺增生；（5）骨关节炎；（6）胃食管反流病；（7）滑囊炎；（8）心律失常；（9）白内障；（10）抑郁症。在患者开始治疗前6个月及开始治疗后12个月进行持续随访。对治疗费用和发生重大事件的可能性进行了研究。
心律失常、骨关节炎、白内障和CAD的特定疾病一年总医疗费用最高。滑囊炎、2型糖尿病和前列腺增生的总医疗费用在400美元至500美元之间。CAD（75%）、骨关节炎（61%）、心律失常（57%）和前列腺增生（40%）的住院费用占总医疗费用的比例最高。对于大多数疾病，药房费用占总费用的比例不到50%。在开始治疗后1年内发生重大临床事件的可能性在患有滑囊炎的男性中最高（23%，手术），其次是前列腺增生（19.2%，急性尿潴留和/或手术）、高血压（13.5%）和糖尿病（9.5%）。
在50岁及以上男性中10种最常见疾病中，成本最高的疾病通常是那些需要大量住院治疗的疾病。前列腺增生、糖尿病和高血压等疾病在开始治疗后1年内发生临床事件的可能性较高。鉴于已知适当药物治疗的使用情况和达到治疗目标的可能性，这些疾病是最有可能得到改善的治疗领域。积极的患者管理（例如，启动/最大化药物治疗）可能有潜力对老年男性的临床和经济结局产生积极影响。
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