Analysis Group, Inc, New York City, New York, USA.
Epilepsia. 2010 May;51(5):838-44. doi: 10.1111/j.1528-1167.2009.02422.x. Epub 2009 Dec 7.
Compare annual direct and indirect costs between privately insured U.S. patients with epileptic partial onset seizures (POS) and matched controls.
One thousand eight hundred fifty-nine patients (including a subset of 758 employees) with >or=1 (POS) diagnosis (ICD-9-CM: 345.4.x-345.7.x), 1999-2004, ages 16-64 years, were identified from a privately insured claims database. Control group was an age- and gender-matched cohort of randomly chosen beneficiaries without epilepsy (ICD-9-CM: 345.x). All were required to have continuous health coverage during 2004 (baseline) and 2005 (study period). Chi-square tests were used to compare baseline comorbidities. Univariate and multivariate analyses were used for comparisons of annual direct (medical and pharmaceutical) and indirect costs during the study period.
Patients with POS were on average 42 years of age, and 57% were women. Patients with POS had significantly higher rates of mental health disorders, migraine, and other neurologic disorders, and higher Charlson comorbidity index (CCI) compared with controls. On average, direct annual costs were significantly higher for POS patients ($11,276) compared with controls ($4,087), p < 0.001; difference of $7,190. Epilepsy-related costs (i.e., costs for antiepileptic drugs, claims with epilepsy or convulsions diagnoses) accounted for $3,290 (29% of direct costs). Employees with POS had substantial and significantly higher indirect (disability- and medically related absenteeism) costs compared with controls ($3,431 vs. $1,511, p < 0.001). Multivariate analyses supported the matched-control univariate findings.
Patients with POS had significantly higher costs compared with matched controls. Epilepsy-related costs underestimate the excess costs of patients with partial onset seizures.
比较有癫痫部分性发作（POS）的美国私人保险患者与匹配对照者每年的直接和间接成本。
从私人保险理赔数据库中确定了 1859 名（包括 758 名员工的子集）≥1 次（POS）诊断（ICD-9-CM：345.4.x-345.7.x）的患者，2004 年年龄为 16-64 岁。对照组为年龄和性别相匹配的无癫痫（ICD-9-CM：345.x）随机选择受益人的队列。所有患者均需在 2004 年（基线）和 2005 年（研究期）期间有连续的健康保险。采用卡方检验比较基线合并症。采用单变量和多变量分析比较研究期间的年直接（医疗和药品）和间接成本。
POS 患者的平均年龄为 42 岁，57%为女性。与对照组相比，POS 患者的精神健康障碍、偏头痛和其他神经系统疾病以及 Charlson 合并症指数（CCI）的发生率显著更高。POS 患者的直接年费用平均明显高于对照组（$11,276 对 $4,087），p<0.001；差异为$7,190。抗癫痫药物、癫痫或惊厥诊断的索赔）占直接费用的 29%（$3,290）。POS 患者的间接（残疾和与医疗相关的旷工）费用显著高于对照组（$3,431 对 $1,511），p<0.001）。多变量分析支持匹配对照的单变量发现。
POS 患者的费用明显高于匹配对照者。癫痫相关费用低估了部分性发作患者的超额费用。
