Analysis Group Inc., 111 Huntington Avenue, Boston, MA 02199, USA.
Respir Med. 2011 Dec;105(12):1861-71. doi: 10.1016/j.rmed.2011.07.001. Epub 2011 Jul 31.
To compare healthcare resource utilization and healthcare costs between COPD patients who used multiple long-acting inhalers versus those who used a single long-acting inhaler.
COPD patients meeting study inclusion criteria were identified in the Market Scan database (2004-2008) and were classified as being a multiple- or single-inhaler user. 11,747 multiple- and single-inhaler users were matched on baseline characteristics to balance disease severity. Patients were followed for 12 months. Incremental differences between the two groups were estimated for: number of exacerbations; time to first exacerbation; all-cause and COPD-related inpatient admissions, inpatient days, emergency room visits, urgent care visits, outpatient visits, and other medical services visits; all-cause and COPD-related healthcare costs. Multivariate regression analyses were also used to control for a number of potentially confounding factors.
After controlling for a number of potentially confounding factors, multiple-inhaler users experienced significantly more exacerbations (0.52; p < .0001) and had a higher risk of exacerbation (HR = 1.40; p < .0001) than single-inhaler users. Multiple-inhaler users also incurred significantly more inpatient admissions (IRR = 1.15; p < .0001), inpatient days (IRR = 1.20; p < .0001), urgent care visits (IRR = 1.10; p = 0.0026), outpatient visits (IRR = 1.06; p < .0001), and other medical services visits (IRR = 1.12; p = <.001) than single-inhaler users, resulting in significantly higher all-cause health care costs ($3,319; p < .0001). Results of COPD-related resource use and costs were comparable.
After controlling for a number of potentially confounding factors, multiple-inhaler users had more exacerbations, a higher risk of exacerbation, and higher healthcare resource utilization and costs compared to single-inhaler users.
比较使用多种长效吸入器和使用单一长效吸入器的 COPD 患者的医疗资源利用和医疗成本。
在 Market Scan 数据库（2004-2008 年）中确定符合研究纳入标准的 COPD 患者，并将其分类为多吸入器或单吸入器使用者。根据基线特征对 11747 名多吸入器和单吸入器使用者进行匹配，以平衡疾病严重程度。对患者进行了 12 个月的随访。估计两组之间的增量差异：加重次数；首次加重时间；全因和 COPD 相关住院入院、住院天数、急诊就诊、紧急护理就诊、门诊就诊和其他医疗服务就诊；全因和 COPD 相关医疗保健费用。还使用多变量回归分析来控制一些潜在的混杂因素。
在控制了一些潜在的混杂因素后，多吸入器使用者经历的加重次数明显更多（0.52；p <.0001），且加重的风险更高（HR = 1.40；p <.0001）。与单吸入器使用者相比，多吸入器使用者的住院入院次数（IRR = 1.15；p <.0001）、住院天数（IRR = 1.20；p <.0001）、紧急护理就诊次数（IRR = 1.10；p = 0.0026）、门诊就诊次数（IRR = 1.06；p <.0001）和其他医疗服务就诊次数（IRR = 1.12；p <.001）也明显更高，导致全因医疗保健费用显著更高（$3319；p <.0001）。COPD 相关资源使用和成本的结果相似。
在控制了一些潜在的混杂因素后，与单吸入器使用者相比，多吸入器使用者的加重次数更多，加重风险更高，医疗资源利用和成本更高。
