Black Jed, Reaven Nancy L, Funk Susan E, McGaughey Karen, Ohayon Maurice, Guilleminault Christian, Ruoff Chad, Mignot Emmanuel
Stanford University, Palo Alto, CA, USA.
Strategic Health Resources, La Canada, CA, USA.
Sleep Med. 2014 May;15(5):522-9. doi: 10.1016/j.sleep.2014.02.001. Epub 2014 Feb 15.
The aim of this study was to characterize health-care utilization, costs, and productivity in a large population of patients diagnosed with narcolepsy in the United States.
This retrospective, observational study using data from the Truven Health Analytics MarketScan Research Databases assessed 5 years of claims data (2006-2010) to compare health-care utilization patterns, productivity, and associated costs among narcolepsy patients (identified by International Classification of Diseases, Ninth Revision (ICD9) narcolepsy diagnosis codes) versus matched controls. A total of 9312 narcolepsy patients (>18 years of age, continuously insured between 2006 and 2010) and 46,559 matched controls were identified.
Compared with controls, narcolepsy subjects had approximately twofold higher annual rates of inpatient admissions (0.15 vs. 0.08), emergency department (ED) visits w/o admission (0.34 vs. 0.17), hospital outpatient (OP) visits (2.8 vs. 1.4), other OP services (7.0 vs. 3.2), and physician visits (11.1 vs. 5.6; all p<0.0001). The rate of total annual drug transactions was doubled in narcolepsy versus controls (26.4 vs. 13.3; p<0.0001), including a 337% and 72% higher usage rate of narcolepsy drugs and non-narcolepsy drugs, respectively (both p<0.0001). Mean yearly costs were significantly higher in narcolepsy compared with controls for medical services ($8346 vs. $4147; p<0.0001) and drugs ($3356 vs. $1114; p<0.0001).
Narcolepsy was found to be associated with substantial personal and economic burdens, as indicated by significantly higher rates of health-care utilization and medical costs in this large US group of narcolepsy patients.
本研究旨在描述美国大量发作性睡病患者的医疗保健利用情况、成本和生产力。
这项回顾性观察研究使用了Truven Health Analytics MarketScan研究数据库的数据，评估了5年的索赔数据（2006 - 2010年），以比较发作性睡病患者（通过国际疾病分类第九版（ICD9）发作性睡病诊断代码识别）与匹配对照组之间的医疗保健利用模式、生产力和相关成本。共识别出9312名发作性睡病患者（年龄>18岁，2006年至2010年持续参保）和46559名匹配对照组。
与对照组相比，发作性睡病患者的年度住院率（0.15对0.08）、未住院的急诊科就诊率（0.34对0.17）、医院门诊就诊率（2.8对1.4）、其他门诊服务率（7.0对3.2）和医生就诊率（11.1对5.6；所有p<0.0001）约高出两倍。发作性睡病患者的年度药物交易总量是对照组的两倍（26.4对13.3；p<0.0001），其中发作性睡病药物和非发作性睡病药物的使用率分别高出337%和72%（均p<0.0001）。与对照组相比，发作性睡病患者的医疗服务年均成本（8346美元对4147美元；p<0.0001）和药物年均成本（3356美元对1114美元；p<0.0001）显著更高。
在美国这一大群发作性睡病患者中，发作性睡病被发现与巨大的个人和经济负担相关，这表现为医疗保健利用率和医疗成本显著更高。
