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利用美国商业保险人群的数据评估尖锐湿疣的发病率和经济负担。

Assessing incidence and economic burden of genital warts with data from a US commercially insured population.

作者信息

Hoy Tracey, Singhal Puneet K, Willey Vincent J, Insinga Ralph P

机构信息

HealthCore, Inc., Fifth Floor, 800 Delaware Avenue, Wilmington, DE 19801, USA.

出版信息

Curr Med Res Opin. 2009 Oct;25(10):2343-51. doi: 10.1185/03007990903136378.

Abstract

OBJECTIVE

This study examined the incidence of and healthcare costs attributable to genital warts within a large US commercially insured, geographically dispersed population.

RESEARCH DESIGN AND METHODS

Using a retrospective cohort study design, this longitudinal analysis assessed administrative claims of integrated medical and pharmacy encounters from five Blue Cross Blue Shield health plans. Genital warts cases were identified using a methodology previously described by Insinga et al.

MAIN OUTCOME MEASURES

Age- and gender-specific incidence of genital warts per 1000 person-years in 2004, and duration-of-episode attributable direct medical costs (2004 US dollars) and healthcare resource utilization of cases diagnosed in 2002. Overall outcome measures were age- and gender-adjusted to the 2004 US civilian population.

RESULTS

Genital warts incidence in 2004 was 1.2/1000 females and 1.1/1000 males. Incidence was highest among females aged 20-24 (4.6/1000) and males aged 25-29 (2.7/1000). Projected overall incidence was over 340,000 cases in 2004. Mean duration-of-episode per incident case in 2002 was 95.4 days (males 116.3 days; females 69.7 days). Mean ambulatory visits per episode were 1.5 for females and 1.9 for males, with <1 drug prescription/episode. Mean costs were $647/episode ($745 males; $528 females). The 2004 estimated economic burden was $760 per 1000 individuals in the general population with the total exceeding $220 million.

LIMITATIONS

Only those genital warts cases that sought evaluation or for which the treating provider was covered by the health plan were captured in the study.

CONCLUSIONS

Genital warts represent a significant health and cost burden in the US. Adoption of novel healthcare technologies such as vaccines along with traditional interventions such as physician education of signs and symptoms, condom use and abstinence or limiting number of sexual partners may significantly help reduce the burden of genital warts.

摘要

目的

本研究调查了美国一个大型商业保险覆盖、地域分散的人群中尖锐湿疣的发病率及相关医疗费用。

研究设计与方法

采用回顾性队列研究设计,这项纵向分析评估了来自五个蓝十字蓝盾健康计划的综合医疗和药房就诊的行政索赔数据。尖锐湿疣病例通过Insinga等人先前描述的方法进行识别。

主要观察指标

2004年每1000人年按年龄和性别划分的尖锐湿疣发病率,以及2002年确诊病例的发作期直接医疗费用(2004美元)和医疗资源利用情况。总体观察指标根据2004年美国平民人口进行了年龄和性别调整。

结果

2004年尖锐湿疣发病率为女性1.2/1000,男性1.1/1000。发病率在20 - 24岁女性中最高(4.6/1000),在25 - 29岁男性中最高(2.7/1000)。2004年预计总发病率超过340,000例。2002年每个病例的平均发作期为95.4天(男性116.3天;女性69.7天)。每次发作女性平均门诊就诊次数为1.5次,男性为1.9次,每次发作药物处方<1张。平均费用为每次发作647美元(男性745美元;女性528美元)。2004年估计普通人群中每1000人经济负担为760美元,总计超过2.2亿美元。

局限性

本研究仅纳入了那些寻求评估或其治疗医生在健康计划覆盖范围内的尖锐湿疣病例。

结论

尖锐湿疣在美国是一个重大的健康和成本负担。采用新型医疗技术如疫苗,以及传统干预措施如医生对症状体征的教育、使用避孕套和禁欲或限制性伴侣数量,可能显著有助于减轻尖锐湿疣的负担。

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