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功能性消化不良在就业人群中的共病患病率和相关成本过高。

Excess comorbidity prevalence and cost associated with functional dyspepsia in an employed population.

机构信息

The JeSTARx Group, 18 Hirth Drive , Newfoundland, NJ 07435-1710, USA.

出版信息

Dig Dis Sci. 2012 Jan;57(1):109-18. doi: 10.1007/s10620-011-1822-8. Epub 2011 Jul 13.

Abstract

BACKGROUND

Limited published data exist on the associated comorbid conditions with functional dyspepsia (FD).

AIMS

This study aimed to assess the prevalence, services, and costs related to comorbid conditions associated with FD and the risk of having FD for each comorbid condition.

METHODS

A retrospective database analysis was undertaken using payroll data and adjudicated claims from January 1, 2001, through December 31, 2004 among >300,000 employees. Employees with FD were compared to propensity-score-matched employees without FD (controls). Outcome measures included the prevalence, costs, and utilization of health services for comorbid conditions as defined by the Agency for Healthcare Research and Quality (AHRQ) and the odds ratios of having FD from a multivariate model.

RESULTS

FD employees (N = 1,669) and a 50:1 matched control cohort (N = 83,450) were compared. Compared to matched controls, FD employees were more likely to have all major diagnostic categories. Moreover, 199/261 of the AHRQ's specific categories were more common in the FD cohort. Annual medical costs for the FD cohort were greater than for controls in 155/261 (59%) specific categories and significantly greater (P ≤ 0.05) in 76 categories (29%). Similarly, services were greater for 179/261 (69%) specific categories and significantly greater (P ≤ 0.05) in 110 categories (42%). In a multivariate model, esophageal disorders, gastritis and duodenitis, and abdominal pain were the most associated with having FD (odds ratios 3.8, 3.7, and 3.6, respectively). Only hypertension complications and disorders of the teeth and jaw were significantly negatively associated with FD.

CONCLUSION

There is unexplained excess comorbidity associated with FD which may be a major determining factor for excess healthcare services and costs.

摘要

背景

关于功能性消化不良(FD)相关合并症的已发表数据有限。

目的

本研究旨在评估与 FD 相关的合并症的患病率、服务和成本,以及每种合并症发生 FD 的风险。

方法

使用薪资数据和 2001 年 1 月 1 日至 2004 年 12 月 31 日期间的经裁定理赔数据,对超过 300,000 名员工进行了回顾性数据库分析。将 FD 患者与无 FD(对照)的倾向评分匹配员工进行比较。结果测量包括根据医疗保健研究与质量局(AHRQ)定义的合并症的患病率、成本和卫生服务的使用,以及多变量模型中发生 FD 的比值比。

结果

比较了 1,669 名 FD 员工和 50:1 匹配的对照组队列(n = 83,450)。与匹配的对照组相比,FD 员工更有可能出现所有主要诊断类别。此外,在 FD 队列中更常见 199/261 个 AHRQ 特定类别。FD 队列的年度医疗费用高于对照组 155/261 个(59%)特定类别,在 76 个类别(29%)中差异显著(P ≤ 0.05)。同样,在 179/261 个(69%)特定类别中,服务更高,在 110 个类别(42%)中差异显著(P ≤ 0.05)。在多变量模型中,食管疾病、胃炎和十二指肠炎以及腹痛与 FD 的关联最大(比值比分别为 3.8、3.7 和 3.6)。只有高血压并发症和牙齿及颌骨疾病与 FD 呈显著负相关。

结论

FD 患者存在未解释的过度合并症,这可能是过度医疗服务和成本的主要决定因素。

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