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在医疗保险优势人群中,新诊断出的阿尔茨海默病的临床和经济负担。

The clinical and economic burden of newly diagnosed Alzheimer's disease in a medicare advantage population.

机构信息

Competitive Health Analytics, Inc, Louisville, KY 40202, USA.

出版信息

Am J Alzheimers Dis Other Demen. 2013 Jun;28(4):384-92. doi: 10.1177/1533317513488911. Epub 2013 May 17.

Abstract

BACKGROUND/RATIONALE: Alzheimer's disease (AD) represents a serious public health issue affecting approximately 5.4 million individuals in the United States and is projected to affect up to 16 million by 2050. This study examined health care resource utilization (HCRU), costs, and comorbidity burden immediately preceding new diagnosis of AD and 2 years after diagnosis.

METHODS

This study utilized a claims-based, retrospective cohort design. Medicare Advantage members newly diagnosed with AD (n = 3374) were compared to matched non-AD controls (n = 6748). All patients with AD were required to have 12 months of continuous enrollment prior to AD diagnosis (International Classification of Diseases, Clinical Modification [ICD-9] 331.0), during which time no diagnosis of AD, a related dementia, or an AD medication was observed. Non-AD controls demonstrated no diagnosis of AD, a related dementia, or a prescription claim for an AD medication treatment during their health plan enrollment. Medical and pharmacy claims data were used to measure HCRU, costs, and comorbidity burden over a period of 36 months (12 months pre-diagnosis and 24 months post-diagnosis).

RESULTS

The HCRU and costs were greater for AD members during the year prior to diagnosis and during postdiagnosis years 1 and 2 compared to controls. The AD members also displayed greater comorbidity than their non-AD counterparts during postdiagnosis years 1 and 2, as measured by 2 different comorbidity indices.

CONCLUSIONS

Members newly diagnosed with AD demonstrated greater HCRU, health care costs, and comorbidity burden compared to matched non-AD controls.

摘要

背景/理由:阿尔茨海默病(AD)是一个严重的公共卫生问题,影响了美国约 540 万人,预计到 2050 年将影响多达 1600 万人。本研究考察了 AD 新诊断前 12 个月和诊断后 24 个月的医疗保健资源利用(HCRU)、成本和合并症负担。

方法

本研究采用了基于索赔的回顾性队列设计。新诊断为 AD(n=3374)的 Medicare Advantage 会员与匹配的非 AD 对照组(n=6748)进行比较。所有 AD 患者均需在 AD 诊断前(国际疾病分类,临床修订版[ICD-9]331.0)连续参保 12 个月,在此期间未观察到 AD、相关痴呆或 AD 药物的诊断。非 AD 对照组在其健康计划参保期间未诊断出 AD、相关痴呆或 AD 药物处方。医疗和药房索赔数据用于在 36 个月(诊断前 12 个月和诊断后 24 个月)内测量 HCRU、成本和合并症负担。

结果

与对照组相比,AD 成员在诊断前一年以及诊断后 1 年和 2 年的 HCRU 和成本更高。AD 成员在诊断后 1 年和 2 年期间的合并症也比非 AD 成员多,这是通过两种不同的合并症指数来衡量的。

结论

与匹配的非 AD 对照组相比,新诊断为 AD 的成员表现出更高的 HCRU、医疗保健成本和合并症负担。

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