Davis Keith L, Misurski Derek, Miller Jacqueline M, Bell Timothy J, Bapat Bela
RTI Health Solutions, Research Triangle Park, NC, USA.
Hum Vaccin. 2011 Jan 1;7(1):96-101. doi: 10.4161/hv.7.1.13692.
The combined costs of acute hospitalization and post-discharge follow-up care in patients with meningococcal disease have not been widely documented. In this study, data were retrospectively analyzed from three large databases of hospital discharge records and commercial insurance claims in the US. Cases of meningococcal disease were defined as admissions with an ICD-9-CM diagnosis code in the range of 036.x. From the 2005 HCUP Nationwide Inpatient Sample, 349 (weighted N=1,710) meningococcal-related hospitalizations were identified with a mean facility cost (in 2009 dollars) of $19,526 per admission. Similar estimates ($18,119 and $20,066, respectively) were obtained from 268 admissions identified in the LifeLink (formerly PharMetrics) database during 1999-2007 and from 1,058 hospitalizations in the Perspective Comparative Database (PCD) during 2000-2007. Using insurance claims from LifeLink, we estimated that payers incur an additional $26,178 in non-facility (professional and other ancillary) costs during the course of a meningococcal admission, as well as $22,230 in additional medical and pharmacy expenses for post-discharge care during the ensuing year. The majority of follow-up costs ($14,637) were attributed to repeat hospitalizations. Mean length of stay for meningococcal disease was consistently estimated across databases at 8 to 9 days. Data from the PCD further suggested that meningococcal disease carries, on average, nearly 2 days of intensive care unit utilization. In conclusion, hospital admissions for meningococcal disease are costly to payers. These costs are heightened when non-facility services and post-discharge care are also considered. Awareness of the full cost burden of meningococcal disease is needed when evaluating vaccination programs targeting the disease.
脑膜炎球菌病患者急性住院和出院后后续护理的综合成本尚未得到广泛记录。在本研究中，我们对美国三个大型医院出院记录和商业保险理赔数据库的数据进行了回顾性分析。脑膜炎球菌病病例定义为国际疾病分类第九版临床修订本（ICD - 9 - CM）诊断编码范围为036.x的入院病例。从2005年的医疗保健成本和利用项目全国住院患者样本中，识别出349例（加权N = 1,710）与脑膜炎球菌相关的住院病例，每次入院的平均机构成本（以2009年美元计）为19,526美元。从1999 - 2007年在LifeLink（原PharMetrics）数据库中识别出的268例入院病例以及2000 - 2007年在透视比较数据库（PCD）中的1,058例住院病例中获得了类似的估计值（分别为18,119美元和20,066美元）。利用LifeLink的保险理赔数据，我们估计，在脑膜炎球菌病入院期间，支付方在非机构（专业和其他辅助）成本上额外支出26,178美元，以及在随后一年的出院后护理中额外支出22,230美元用于医疗和药房费用。大部分后续成本（14,637美元）归因于再次住院。各数据库对脑膜炎球菌病的平均住院时长一致估计为8至9天。PCD的数据进一步表明，脑膜炎球菌病平均需要近2天的重症监护病房使用时间。总之，脑膜炎球菌病的住院治疗对支付方来说成本高昂。当考虑非机构服务和出院后护理时，这些成本会更高。在评估针对该疾病的疫苗接种项目时，需要了解脑膜炎球菌病的全部成本负担。
