Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
Adv Ther. 2009 Oct;26(10):947-58. doi: 10.1007/s12325-009-0073-y. Epub 2009 Nov 11.
The purpose of this research was to assess the impact of transition from ocular hypertension (OHT) to primary open-angle glaucoma (POAG) on healthcare charges.
A case-control group was identified using PharMetrics claims database (1998-2005). Cases (n=1055) had a transition from OHT to POAG based on International Classification of Disease, Ninth Edition coding (ICD-9=365.11). Controls (n=2110) retained an ICD-9 code for OHT (ICD-9=365.04) and were matched to cases (2:1) on gender, age, diagnosis year, and follow-up time post-diagnosis. The index date marked the transition for cases and a date of similar duration after OHT diagnosis for controls. Conditional logistic regression and multiple linear regression models determined the impact of transitioning on healthcare charges.
Cases had significantly higher increases in ophthalmology-related charges ($797 vs. -$385, P<0.0001) but similar total healthcare charges ($1689 vs. $1386, P=0.8277) from the year pre- to year post-index date when compared with controls. After adjusting for key covariates, cases were 1.56 times (95% CI: 1.33-1.82) more likely to have increased total charges and 5.26 times (95% CI: 4.27-6.47) more likely to have increased ophthalmology-related charges compared with controls. In multiple linear regression analyses, cases experienced $48 (55%) higher increases in ophthalmology-related charges from the year pre- to year post-index date compared with controls ($85 vs. $37, respectively; P<0.0001).
Patients with a transition from OHT to POAG based on ICD-9 coding had higher ophthalmology-related charges the year after transition compared with patients who retained a code for OHT. Prevention of this transition could result in healthcare resource savings.
本研究旨在评估从高眼压症（OHT）到原发性开角型青光眼（POAG）的转变对医疗费用的影响。
使用 PharMetrics 索赔数据库（1998-2005 年）确定病例对照组。病例组（n=1055）根据国际疾病分类，第九版编码（ICD-9=365.11）从 OHT 转变为 POAG。对照组（n=2110）保留 OHT 的 ICD-9 编码（ICD-9=365.04），并根据性别、年龄、诊断年份和诊断后随访时间与病例（2:1）匹配。索引日期标记病例的转变，对照组为 OHT 诊断后类似时间的日期。条件逻辑回归和多元线性回归模型确定了转变对医疗费用的影响。
与对照组相比，病例组在眼科相关费用方面的增加明显更高（$797 比-$385，P<0.0001），但总医疗费用相似（$1689 比$1386，P=0.8277）。在校正关键协变量后，病例组增加总费用的可能性是对照组的 1.56 倍（95%CI：1.33-1.82），增加眼科相关费用的可能性是对照组的 5.26 倍（95%CI：4.27-6.47）。在多元线性回归分析中，与对照组相比，病例组在索引日期前一年到索引日期后一年的眼科相关费用增加了$48（55%）（$85 比$37，分别；P<0.0001）。
根据 ICD-9 编码，从 OHT 转变为 POAG 的患者在转变后的一年中眼科相关费用更高，与保留 OHT 编码的患者相比。预防这种转变可能会节省医疗资源。
