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美国丙型肝炎感染的人文和经济影响。

Humanistic and economic impacts of hepatitis C infection in the United States.

机构信息

Health Sciences Practice, Kantar Health, New York, NY 10010, USA.

出版信息

J Med Econ. 2010;13(4):709-18. doi: 10.3111/13696998.2010.535576. Epub 2010 Nov 22.

DOI:10.3111/13696998.2010.535576
PMID:21091098
Abstract

OBJECTIVE

Prior research examining the effect of hepatitis C virus (HCV) on health-related quality of life (HRQoL) and healthcare costs is flawed because non-patient controls were not adequately comparable to HCV patients. The current study uses a propensity score matching methodology to address the following research question: is the presence of diagnosed hepatitis C (HCV) associated with poorer health-related quality of life (HRQoL) and greater healthcare resource use?

METHODS

Using data from the 2009 US National Health and Wellness Survey, patients who reported a HCV diagnosis (n = 695) were compared to propensity-matched controls (n = 695) on measures of HRQoL and healthcare resource use. All analyses applied sampling weights to project to the US population.

RESULTS

HCV patients reported significantly lower levels of HRQoL relative to the matched-control group, including the physical component score (39.6 vs. 42.7, p < 0.0001) and health utilities (0.63 vs. 0.66, p < 0.0001). The number of emergency room visits (0.59 vs. 0.44, p < 0.05) and physician visits (7.7 vs. 5.9, p < 0.05) in the past 6 months were significantly higher for the HCV group relative to matched controls.

CONCLUSION

The results of this study suggest that HCV represents a substantial burden on patients by having a significant and clinically-relevant impact on key dimensions of HRQoL as well as on utilization of healthcare resources, the latter of which would result in increased direct medical costs.

LIMITATIONS

Due to limitations of the internet survey approach (e.g., inability to confirm HCV diagnosis), future research is needed to confirm these findings.

摘要

目的

先前研究检查丙型肝炎病毒(HCV)对健康相关生活质量(HRQoL)和医疗保健成本的影响存在缺陷,因为非患者对照与 HCV 患者没有充分可比。本研究使用倾向评分匹配方法来解决以下研究问题:诊断出的丙型肝炎(HCV)的存在是否与较差的健康相关生活质量(HRQoL)和更多的医疗资源使用相关?

方法

使用来自 2009 年美国国家健康和健康调查的数据,将报告 HCV 诊断的患者(n = 695)与倾向评分匹配的对照组(n = 695)在 HRQoL 和医疗资源使用方面进行比较。所有分析均应用抽样权重来预测美国人口。

结果

HCV 患者报告的 HRQoL 明显低于匹配对照组,包括生理成分评分(39.6 对 42.7,p < 0.0001)和健康效用(0.63 对 0.66,p < 0.0001)。在过去 6 个月中,急诊就诊次数(0.59 对 0.44,p < 0.05)和医生就诊次数(7.7 对 5.9,p < 0.05)显著更高。

结论

本研究结果表明,HCV 对患者造成了重大负担,对 HRQoL 的关键维度以及医疗资源的利用产生了重大且具有临床意义的影响,后者将导致直接医疗成本增加。

局限性

由于互联网调查方法的限制(例如,无法确认 HCV 诊断),需要进一步的研究来证实这些发现。

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