Eli Lilly and Company, Indianapolis, IN.
J Pain Res. 2012;5:23-30. doi: 10.2147/JPR.S27275. Epub 2012 Feb 1.
Osteoarthritis is a chronic and costly condition affecting 14% of adults in the US, and has a significant impact on patient quality of life. This retrospective cohort study compared direct health care utilization and costs between patients with osteoarthritis and a matched control group without osteoarthritis.
MarketScan(®) databases were used to identify adult patients with an osteoarthritis claim (ICD-9-CM, 715.xx) in 2007, and the date of first diagnosis served as the index. Patients were excluded if they did not have 12 months of continuous health care benefit prior to and following the index date, were aged <18 years, or lacked a second diagnosis code for osteoarthritis between 15 and 365 days pre-index or post-index. Osteoarthritis patients were matched 1:1 to patients without osteoarthritis for age group, gender, geographic region, health plan type, and Medicare eligibility. Multivariate analyses were conducted to assess for differences in utilization and costs, controlling for differences between cohorts.
The study sample included 258,237 patients with osteoarthritis and 258,237 matched controls without osteoarthritis. Most patients were women and over 55 years of age. Patients with osteoarthritis had significantly higher pre-index rates of comorbidity than controls. Mean total adjusted direct costs for osteoarthritis patients were more than double those for the control group at US$18,435 (95% confidence interval [CI]: US$18,318-US$18,560) versus US$7494 (95% CI: US$7425-US$7557). Osteoarthritis patients incurred significantly higher inpatient costs at US$6668 (95% CI: US$6587-US$6744) versus US$1756 (95% CI: US$1717-US$1794), outpatient costs at US$7840 (95% CI: US$7786-US$7902) versus US$3675 (95% CI: US$3637-US$3711), and prescription drug costs at US$3213 (95% CI: US$3195-US$3233) versus US$2245 (95% CI: US$2229-US$2262) compared with the controls.
The direct health care costs of osteoarthritis patients were over two times higher than those of similar patients without the condition. The primary drivers of the cost difference were comorbidities and inpatient costs.
骨关节炎是一种影响美国 14%成年人的慢性且昂贵的疾病，对患者的生活质量有重大影响。这项回顾性队列研究比较了骨关节炎患者和无骨关节炎的匹配对照组之间的直接医疗保健利用和成本。
使用 MarketScan®数据库确定 2007 年患有骨关节炎（ICD-9-CM，715.xx）的成年患者，以首次诊断日期作为索引。如果患者在索引日期之前和之后没有 12 个月的连续医疗保健福利，年龄<18 岁，或在索引前或索引后 15 至 365 天内没有第二个骨关节炎诊断代码，则将其排除在外。将骨关节炎患者按年龄组、性别、地理位置、健康计划类型和医疗保险资格与无骨关节炎的患者 1:1 匹配。进行多变量分析以评估利用和成本的差异，同时控制队列之间的差异。
研究样本包括 258,237 名骨关节炎患者和 258,237 名无骨关节炎的匹配对照组。大多数患者为女性，年龄超过 55 岁。与对照组相比，骨关节炎患者的合并症发生率在指数前明显更高。骨关节炎患者的总调整后直接医疗费用为 18435 美元（95%置信区间[CI]：18318 美元至 18560 美元），是对照组的两倍多，对照组为 7494 美元（95%CI：7425 美元至 7557 美元）。与对照组相比，骨关节炎患者的住院费用为 6668 美元（95%CI：6587 美元至 6744 美元），门诊费用为 7840 美元（95%CI：7786 美元至 7902 美元），处方药费用为 3213 美元（95%CI：3195 美元至 3233 美元），2245 美元（95%CI：2229 美元至 2262 美元）。
骨关节炎患者的直接医疗保健成本是无该疾病患者的两倍多。成本差异的主要驱动因素是合并症和住院费用。
