Division of Nephrology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Kidney Blood Press Res. 2009;32(2):110-8. doi: 10.1159/000213166. Epub 2009 Apr 17.
BACKGROUND/AIMS: We conducted a retrospective claims database analysis to examine the association of anaemia and anaemia management with healthcare expenditure and utilization in patients with chronic kidney disease (CKD) before the onset of dialysis.
Claims data on patients (aged > or =15 years) with CKD were collected from the Medstat Marketscan Commercial and Medicare Databases between 2000 and 2005. Using these data, patients were evaluated for anaemia of CKD, anaemia treatment status and healthcare costs and use.
Of the 37,105 CKD patients, 9,807 (26%) had incident anaemia; 59% of these received at least one type of anaemia treatment, with 48% receiving an erythropoiesis-stimulating agent. The total adjusted per patient per month healthcare expenditure for all CKD patients was USD 2,749. Patients with anaemia had significantly greater overall expenditure, which was 38% higher than those without anaemia. Total expenditure was 17% higher for untreated versus treated anaemic patients, largely due to higher inpatient expenditure in the untreated cohort.
This analysis suggests that the presence of anaemia is associated with greater medical expenditure in patients with CKD. However, we found that anaemia management may help to lower inpatient costs associated with anaemia in the CKD population.
背景/目的:我们进行了一项回顾性理赔数据库分析,以研究在开始透析之前,慢性肾脏病(CKD)患者的贫血及其管理与医疗保健支出和利用之间的关系。
从 2000 年至 2005 年,Medstat Marketscan 商业和医疗保险数据库中收集了患有 CKD 的患者(年龄> =15 岁)的理赔数据。使用这些数据,评估了 CKD 贫血、贫血治疗状况以及医疗保健费用和使用情况。
在 37105 例 CKD 患者中,有 9807 例(26%)患有新发贫血;其中 59%接受了至少一种类型的贫血治疗,48%接受了促红细胞生成素刺激剂治疗。所有 CKD 患者的每位患者每月的总调整医疗保健支出为 2749 美元。患有贫血的患者总支出明显更高,比没有贫血的患者高 38%。未治疗的贫血患者的总支出比接受治疗的贫血患者高 17%,这主要是由于未治疗组的住院支出较高。
这项分析表明,贫血的存在与 CKD 患者的医疗支出增加有关。然而,我们发现,贫血管理可能有助于降低 CKD 人群中与贫血相关的住院费用。