Lanzkron Sophie, Haywood Carlton, Fagan Peter J, Rand Cynthia S
Div. of Hematology, Dept. of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Suite 7300, Baltimore, MD 21205, USA.
J Health Care Poor Underserved. 2010 Feb;21(1):277-86. doi: 10.1353/hpu.0.0272.
This study investigated hydroxyurea use in people with sickle cell disease (SCD) outside of a research setting. Pharmacy data, outpatient visits, hospital admissions, and length of stay were assessed for all patients with SCD enrolled in a Medicaid managed care organization in Maryland. Three hundred and ninety (390) people with SCD were covered between the years 2001-2005. A large majority (85.9%) never had a claim for a hydroxyurea refill. Hydroxyurea users had higher admission rates than non-hydroxyurea users (5 vs. 1.5, p=.004). Patients who were in the highest tertile of refills of hydroxyurea had significantly fewer hospital admissions than patients in the lowest tertile (2.44 vs. 7.57, p=.043). Patients with the lowest hydroxyurea refill usage had significantly higher mean costs per month enrolled than those with the highest number ($4,553 vs. $2,017, p=.031). Hydroxyurea was underutilized in this patient population. Patients with more regular refills of hydroxyurea had fewer admissions to the hospital and markedly decreased costs.
本研究调查了镰状细胞病（SCD）患者在非研究环境下使用羟基脲的情况。对马里兰州一家医疗补助管理式医疗组织中所有登记的SCD患者的药房数据、门诊就诊情况、住院情况及住院时长进行了评估。2001年至2005年期间，共有390名SCD患者参保。绝大多数（85.9%）患者从未有过羟基脲续方申请。羟基脲使用者的住院率高于非使用者（5次 vs. 1.5次，p = 0.004）。羟基脲续方次数处于最高三分位数的患者的住院次数显著少于处于最低三分位数的患者（2.44次 vs. 7.57次，p = 0.043）。羟基脲续方使用量最低的患者每月的平均参保费用显著高于续方使用量最高的患者（4553美元 vs. 2017美元，p = 0.031）。该患者群体中羟基脲使用不足。羟基脲续方更规律的患者住院次数更少，费用也显著降低。
