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患有流感及流感相关并发症患者的年度全因医疗保健费用:美国管理式医疗数据库分析。

Annual all-cause healthcare costs among influenza patients with and without influenza-related complications: analysis of a United States managed care database.

机构信息

RTI Health Solutions, 200 Park Offices Drive, Post Office Box 12194, Research Triangle Park, NC 27709, USA.

出版信息

Appl Health Econ Health Policy. 2013 Apr;11(2):119-28. doi: 10.1007/s40258-013-0020-6.

Abstract

BACKGROUND

Several studies have reported that patients with influenza have a high risk of developing complications such as secondary infections, exacerbation of cardiovascular conditions and asthma. However, limited data exists on the healthcare cost burden for influenza patients with and without influenza-related complications.

OBJECTIVE

We compared healthcare utilization and costs among influenza patients with related complications versus patients without complications.

METHODS

In this retrospective database analysis (LifeLink database: 1998-2009) of a US managed care database, we selected patients diagnosed with influenza during influenza seasons and categorized them as complicated or uncomplicated based on the presence or absence of a diagnosis for a related complication in the year following their influenza diagnosis. Multivariable regression analyses were conducted to compare all-cause utilization and costs (adjusted to 2009 US dollars) between the two groups.

RESULTS

We identified 54,469 patients of which ~65 % had evidence for at least one complication. Patients with complicated influenza had a 1.5-fold higher rate of inpatient utilization compared with uncomplicated cases (p < 0.001). Significantly higher covariate-adjusted predicted mean annual costs were also observed among complicated influenza patients across all care (p-values <0.001 for all comparisons).

CONCLUSION

Healthcare costs were twice as high among influenza patients with complications versus those without, with inpatient and outpatient services being the primary cost drivers. Now with the universal recommendation for seasonal influenza vaccination for all individuals ≥6 months of age, improvement in coverage rates may help reduce the healthcare utilization and costs associated with influenza and associated complications.

摘要

背景

多项研究报告称,流感患者有发生继发感染、心血管疾病和哮喘恶化等并发症的高风险。然而,关于有和无流感相关并发症的流感患者的医疗保健费用负担,数据有限。

目的

我们比较了有相关并发症的流感患者与无并发症的流感患者的医疗保健利用情况和费用。

方法

在这项回顾性数据库分析(LifeLink 数据库:1998-2009 年)中,我们选择了在流感季节被诊断为流感的患者,并根据他们流感诊断后一年是否存在相关并发症的诊断,将他们分为有并发症和无并发症两类。采用多变量回归分析比较两组之间的全因利用情况和费用(调整为 2009 年美元)。

结果

我们共确定了 54469 名患者,其中约 65%的患者有至少一种并发症的证据。与无并发症病例相比,有并发症流感患者的住院利用率高 1.5 倍(p<0.001)。在所有治疗中,也观察到有并发症流感患者的调整后预测平均年度费用明显更高(所有比较的 p 值均<0.001)。

结论

与无并发症的流感患者相比,有并发症的流感患者的医疗保健费用高出一倍,住院和门诊服务是主要的费用驱动因素。现在,所有≥6 个月的个体都被普遍建议接种季节性流感疫苗,提高覆盖率可能有助于减少与流感和相关并发症相关的医疗保健利用和费用。

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