Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.
J Am Geriatr Soc. 2011 May;59(5):827-36. doi: 10.1111/j.1532-5415.2011.03403.x.
To determine and compare healthcare utilization and costs for younger and older adults with postherpetic neuralgia (PHN) and painful diabetic peripheral neuropathy (DPN).
Retrospective cohort analysis.
Inpatient and outpatient care.
Patients with PHN or painful DPN were selected from administrative databases of healthcare claims and matched to controls who had a diagnosis of herpes zoster without persistent pain or a diagnosis of diabetes mellitus without neurological complications using propensity scores for demographic and clinical factors.
Excess per-person utilization and costs attributable to PHN and painful DPN were calculated for diagnostic procedures, medications, and interventional treatments related to neuropathic pain.
In both groups, the patterns of significant excess per-patient utilization and excess per-patient costs were similar for diagnostic procedures, medications, and interventional treatments, but patterns of utilization and costs of these procedures and treatments differed depending on age and the specific condition examined.
The results contribute to and expand current knowledge of the excess healthcare usage and costs of two prevalent peripheral neuropathic pain conditions and can be used in future studies of the cost-effectiveness of treatment and preventive interventions.
确定并比较带状疱疹后神经痛(PHN)和痛性糖尿病周围神经病变(DPN)患者中年轻和老年患者的医疗保健利用和费用。
回顾性队列分析。
住院和门诊护理。
从医疗保健索赔的行政数据库中选择患有 PHN 或痛性 DPN 的患者,并使用倾向评分对人口统计学和临床因素进行匹配,以选择没有持续性疼痛的带状疱疹或没有神经并发症的糖尿病诊断的对照患者。
计算与神经病理性疼痛相关的诊断程序、药物和介入性治疗的人均超支利用和费用。
在两组中,与诊断程序、药物和介入性治疗相关的人均超支利用和人均超支费用模式相似,但这些程序和治疗的利用和费用模式因年龄和具体检查条件而异。
这些结果有助于并扩展了目前对两种常见周围神经病理性疼痛疾病的过度医疗保健使用和费用的认识,并可用于未来治疗和预防干预成本效益的研究。