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阻塞性肺疾病合并睡眠呼吸暂停综合征患者的经济负担加重。

Elevated economic burden in obstructive lung disease patients with concomitant sleep apnea syndrome.

机构信息

Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, MD, 21201, USA.

出版信息

Sleep Breath. 2009 Nov;13(4):317-23. doi: 10.1007/s11325-009-0266-2. Epub 2009 May 30.

Abstract

PURPOSE

The purpose of this study is to examine the incremental economic burden of sleep apnea syndrome (SAS) among individuals with concomitant asthma, chronic obstructive pulmonary disease (COPD), or both (i.e., asthma/COPD).

METHODS

Maryland Medicaid claims data were used to identify beneficiaries with asthma (n = 3,072), COPD (n = 3,455), or both (n = 2,604). We compared patient's baseline characteristics by SAS and stratified the analyses by disease cohort to examine the effect of SAS on medical utilization and cost.

RESULTS

SAS was more prevalent among beneficiaries with asthma/COPD (6.72%) than beneficiaries with COPD alone (2.87%) or asthma alone (2.15%). Asthma/COPD and COPD beneficiaries with SAS had more medical service claims (p < 0.001) and higher medical cost than beneficiaries without SAS: $5,773 and $4,155 in excess costs among asthma/COPD (p = 0.037) and COPD patients (p = 0.035), respectively. Medical utilization and cost did not differ by SAS in asthma patients (p = 0.567).

CONCLUSIONS

SAS may add additional economic burden on beneficiaries who already have COPD or asthma/COPD.

摘要

目的

本研究旨在探讨合并哮喘、慢性阻塞性肺疾病(COPD)或两者(即哮喘/COPD)的个体中睡眠呼吸暂停综合征(SAS)的额外经济负担。

方法

使用马里兰州医疗补助数据识别患有哮喘(n=3072)、COPD(n=3455)或两者(n=2604)的受益人的数据。我们通过 SAS 比较了患者的基线特征,并按疾病队列分层分析,以研究 SAS 对医疗利用和成本的影响。

结果

SAS 在哮喘/COPD 受益人中更为普遍(6.72%),而在 COPD 受益人中仅为 2.87%,在哮喘受益人中仅为 2.15%。患有哮喘/COPD 和 COPD 的 SAS 受益人的医疗服务索赔(p<0.001)和医疗费用(p<0.001)均高于无 SAS 的受益人群:哮喘/COPD 患者的超额费用为 5773 美元,COPD 患者的超额费用为 4155 美元。在哮喘患者中,SAS 对医疗利用率和成本没有影响(p=0.567)。

结论

SAS 可能会给已经患有 COPD 或哮喘/COPD 的受益人群带来额外的经济负担。

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