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疼痛性神经病变:对魁北克省医疗保险局数据库的分析

Painful neuropathic disorders: an analysis of the Régie de l'Assurance Maladie du Québec database.

作者信息

Lachaine J, Gordon A, Choinière M, Collet J P, Dion D, Tarride J-E

机构信息

University of Montreal, Montreal, Quebec, Canada.

出版信息

Pain Res Manag. 2007 Spring;12(1):31-7. doi: 10.1155/2007/713835.

Abstract

BACKGROUND/OBJECTIVE: Painful neuropathic disorders (PNDs) refer to neurological disorders involving nerves in which pain is a predominant symptom. In most cases, PNDs involve the peripheral nerves. Treatment of PNDs is likely to use large health care resources. However, little is known about the economic burden of PNDs in Canada.

METHOD

The present study was performed using data from a random sample of patients covered by the Régie de l'Assurance Maladie du Quebec drug plan. Subjects with a diagnosis of a peripheral PND were identified. Comorbidities, pain-related medication use and resource utilization were compared between PND patients and control patients without PNDs matched for age and sex in a 1:1 ratio.

RESULTS

A total of 4912 patients with PNDs were identified. A higher level of comorbidities was found in the PND group (Von Korff chronic disease score 3.91 versus 2.54; P<0.001). The proportion of users of pain-related medications was significantly higher in the PND cohort than in the control group (chi-squared; P<0.001). The average annual number of physician visits was also significantly higher in the PND group than in the control group (14.7 versus 6.4; P<0.001). From a health ministry perspective, costs of health care resources were significantly higher in the PND group (4,163 dollars versus 1,846 dollars; P<0.001). The proportion of potentially inappropriate medications was 34% among those 65 years of age or older.

CONCLUSIONS

PNDs are associated with a higher level of comorbidities, higher medical resources utilization and higher health care costs than non-PND conditions.

摘要

背景/目的:疼痛性神经病变(PND)是指以疼痛为主要症状的累及神经的神经系统疾病。在大多数情况下,PND累及周围神经。PND的治疗可能会消耗大量医疗资源。然而,加拿大PND的经济负担鲜为人知。

方法

本研究使用魁北克医疗保险药物计划覆盖的患者随机样本数据进行。识别出诊断为周围性PND的受试者。将PND患者与年龄和性别1:1匹配的无PND的对照患者在合并症、疼痛相关药物使用和资源利用方面进行比较。

结果

共识别出4912例PND患者。PND组的合并症水平更高(Von Korff慢性病评分3.91对2.54;P<0.001)。PND队列中疼痛相关药物使用者的比例显著高于对照组(卡方检验;P<0.001)。PND组的平均每年就诊次数也显著高于对照组(14.7对6.4;P<0.001)。从卫生部的角度来看,PND组的医疗资源成本显著更高(4163美元对1846美元;P<0.001)。65岁及以上人群中潜在不适当药物的比例为34%。

结论

与非PND情况相比,PND与更高水平的合并症、更高的医疗资源利用和更高的医疗成本相关。

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