Thomas Jefferson University, Philadelphia, PA USA.
J Med Econ. 2010;13(4):583-90. doi: 10.3111/13696998.2010.518114. Epub 2010 Sep 13.
To describe healthcare utilization and costs among commercially insured women with a diagnosis of hypoactive sexual desire disorder (HSDD) in the US and to compare them with an age-matched control cohort.
The Thomson Reuters MarketScan * Commercial Database was used to identify women aged 18-64 with an ICD-9-CM coded diagnosis of HSDD from 1/1/1998 to 9/30/2006. A control group of women with no diagnosis of any sexual dysfunction was matched 3:1 to cases based on age, health plan, and enrolment period. Healthcare utilization and costs were examined in the year prior to (pre-period) and following (post-period) index. Multivariate analyses were used to determine the adjusted difference in cost between women with and without HSDD in the post-period.
In both the pre- and post-periods, women with HSDD had more outpatient office visits, radiology services, prescription medication use, and medical visits (e.g., laboratory and outpatient surgeries) relative to controls. In the 12-month post-period, women with HSDD had significantly higher total costs relative to controls ($5,504 ± 11,132 vs. $4,606 ± 12,601, p < 0.001). After adjusting for clinical characteristics, women with HSDD had total healthcare expenditures that were 16.8% higher than controls (p < 0.001).
There is a potential for selection bias among the women who actually received a diagnosis of HSDD from a clinician. Women who received a diagnosis may be different from women without a diagnosis in ways that cannot be measured in this study. Additionally, it is possible that some women in the control group had HSDD but were undiagnosed. To the extent that the control group included women who did have HSDD, the study estimates of differences between the two groups would be underestimated.
Women diagnosed with HSDD use significantly more healthcare services than women without diagnosed sexual dysfunction. These higher costs are driven by a greater use of outpatient services and prescription medications.
描述美国商业保险女性中诊断为性欲减退障碍(HSDD)的患者的医疗保健利用情况和费用,并与年龄匹配的对照组进行比较。
使用 Thomson Reuters MarketScan * 商业数据库,于 1998 年 1 月 1 日至 2006 年 9 月 30 日,确定了 ICD-9-CM 编码诊断为 HSDD 的 18-64 岁女性。根据年龄、健康计划和入组期,将未诊断为任何性功能障碍的女性 3:1 匹配为病例。在索引前(预期)和后(后)期间检查医疗保健的利用情况和费用。使用多元分析来确定后期间 HSDD 患者与无 HSDD 患者的成本调整差异。
在预期间和后期间,HSDD 女性的门诊就诊次数、放射服务、处方药物使用和医疗访问(如实验室和门诊手术)均多于对照组。在后 12 个月期间,HSDD 女性的总费用明显高于对照组($5504±11132 比 $4606±12601,p <0.001)。调整临床特征后,HSDD 患者的总医疗保健支出比对照组高 16.8%(p <0.001)。
实际上从临床医生那里获得 HSDD 诊断的女性可能存在选择偏差。从诊断上看,接受诊断的女性可能与没有诊断的女性在无法在本研究中测量的方面有所不同。此外,控制组中的一些女性可能患有 HSDD,但未被诊断。在控制组中包含确实患有 HSDD 的女性的情况下,对两组之间差异的研究估计将被低估。
诊断为 HSDD 的女性比没有诊断为性功能障碍的女性使用更多的医疗保健服务。这些较高的费用是由更多的门诊服务和处方药物使用所驱动的。