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糖尿病患者甲状腺疾病相关的增量医疗支出。

Incremental Healthcare Expenditures Associated with Thyroid Disorders among Individuals with Diabetes.

作者信息

Raval Amit D, Sambamoorthi Usha

机构信息

Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, P.O. Box 9510, Morgantown, WV-26505, USA.

出版信息

J Thyroid Res. 2012;2012:418345. doi: 10.1155/2012/418345. Epub 2012 Dec 11.

Abstract

Objective. To estimate incremental healthcare expenditures associated with thyroid disorders among individuals with diabetes. Research Design and Methods. Cross-sectional study design with data on adults over 20 years of age with diabetes (N = 4, 490) from two years (2007 and 2009) of the Medical Expenditure Panel Survey (MEPS) was used. Ordinary least square regressions on log-transformed total expenditures and type of healthcare expenditures (inpatient, emergency room, outpatient, prescription drug, and other) were performed to estimate the incremental expenditures associated with thyroid disorders after controlling for demographic, socioeconomic, health status, lifestyle risk factors, macrovascular comorbid conditions (MCCs), and chronic conditions (CCs). Results. Among individuals with diabetes, those with thyroid disorders had significantly greater average annual total healthcare expenditures ($15,182) than those without thyroid disorders ($11,093). Individuals with thyroid disorders had 34.3% greater total healthcare expenditures compared to those without thyroid disorders, after controlling for demographic, socio-economic, and perceived health status. Furthermore, controlling for CCs and MCCs, this increase in expenditures was reduced to 21.4%. Conclusions. Among individuals with diabetes, thyroid disorders were associated with greater healthcare expenditures; such excess expenditures may be due to CCs and MCCs. Comanagement of CCs and reducing MCCs may be a pathway to reduce high healthcare expenditures.

摘要

目的。评估糖尿病患者中甲状腺疾病相关的额外医疗支出。研究设计与方法。采用横断面研究设计,数据来源于医疗支出面板调查(MEPS)2007年和2009年两年中20岁以上的成年糖尿病患者(N = 4490)。对经对数转换的总支出和医疗支出类型(住院、急诊室、门诊、处方药及其他)进行普通最小二乘回归,以估计在控制了人口统计学、社会经济、健康状况、生活方式风险因素、大血管合并症(MCCs)和慢性病(CCs)后与甲状腺疾病相关的额外支出。结果。在糖尿病患者中,患有甲状腺疾病的患者平均每年的总医疗支出(15,182美元)显著高于未患甲状腺疾病的患者(11,093美元)。在控制了人口统计学、社会经济和自我感知的健康状况后,患有甲状腺疾病的患者的总医疗支出比未患甲状腺疾病的患者高出34.3%。此外,在控制了CCs和MCCs后,这种支出增加幅度降至21.4%。结论。在糖尿病患者中,甲状腺疾病与更高的医疗支出相关;这种额外支出可能归因于CCs和MCCs。对CCs进行共同管理以及减少MCCs可能是降低高额医疗支出的一条途径。

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