美国低钠血症的疾病成本。
Cost of illness of hyponatremia in the United States.
作者信息
Boscoe Audra, Paramore Clark, Verbalis Joseph G
机构信息
United BioSource Corporation, Bethesda, MD, USA.
出版信息
Cost Eff Resour Alloc. 2006 May 31;4:10. doi: 10.1186/1478-7547-4-10.
BACKGROUND
Hyponatremia is a disorder of fluid and electrolyte balance characterized by a relative excess of body water relative to body sodium content. It is the most common electrolyte disorder encountered in clinical medicine and is associated with negative outcomes in many chronic diseases. However, there is limited information in the literature about health care resource use and costs attributable to the effects of the condition. The purpose of this analysis was to estimate the annual cost of illness of hyponatremia in the United States.
METHODS
The study utilized a prevalence-based cost of illness framework that incorporated data from publicly available databases, published literature and a consensus panel of expert physicians. Panel members provided information on: classification of hyponatremia patients, treatment settings for hyponatremia (i.e., hospital, emergency room, doctor's office), and health care resource use associated with the diagnosis and treatment of hyponatremia. Low and high prevalence scenarios were estimated and utilized in a spreadsheet-based cost of illness model. Costs were assigned to units of resources and summarized across treatment settings.
RESULTS
The prevalence estimate for hyponatremia ranged from 3.2 million to 6.1 million persons in the U.S. on an annual basis. Approximately 1% of patients were classified as having acute and symptomatic hyponatremia, 4% acute and asymptomatic, 15%-20% chronic and symptomatic, and 75-80% chronic and asymptomatic. Of patients treated for hyponatremia, 55%-63% are initially treated as inpatients, 25% are initially treated in the emergency room, and 13%-20% are treated solely in the office setting. The direct costs of treating hyponatremia in the U.S. on an annual basis were estimated to range between $1.6 billion and $3.6 billion.
CONCLUSION
Treatment of hyponatremia represents a significant healthcare burden in the U.S. Newer therapies that may reduce the burden of hyponatremia in the inpatient setting could minimize the costs associated with this condition.
背景
低钠血症是一种液体和电解质平衡紊乱，其特征是相对于机体钠含量，机体水分相对过多。它是临床医学中最常见的电解质紊乱，并且与许多慢性疾病的不良后果相关。然而，关于该病症影响所导致的医疗资源使用和成本，文献中的信息有限。本分析的目的是估计美国低钠血症的年度疾病成本。
方法
该研究采用基于患病率的疾病成本框架，纳入了来自公开可用数据库、已发表文献以及专家医生共识小组的数据。小组成员提供了以下信息：低钠血症患者的分类、低钠血症的治疗场所（即医院、急诊室、医生办公室）以及与低钠血症诊断和治疗相关的医疗资源使用情况。估计了低患病率和高患病率情景，并将其用于基于电子表格的疾病成本模型。成本被分配到资源单位，并在各治疗场所进行汇总。
结果
美国低钠血症的患病率估计每年在320万至610万人之间。约1%的患者被归类为急性有症状低钠血症，4%为急性无症状低钠血症，15% - 20%为慢性有症状低钠血症，75% - 80%为慢性无症状低钠血症。在接受低钠血症治疗的患者中，55% - 63%最初作为住院患者接受治疗，25%最初在急诊室接受治疗，13% - 20%仅在门诊接受治疗。美国每年治疗低钠血症的直接成本估计在16亿美元至36亿美元之间。
结论
在美国，低钠血症的治疗是一项重大的医疗负担。可能降低住院环境中低钠血症负担的新疗法可以使与此病症相关的成本降至最低。
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