美国2型糖尿病患者尿路感染的疾病负担

Disease burden of urinary tract infections among type 2 diabetes mellitus patients in the U.S.

作者信息

Yu Shengsheng, Fu Alex Z, Qiu Ying, Engel Samuel S, Shankar Ravi, Brodovicz Kimberly G, Rajpathak Swapnil, Radican Larry

机构信息

Merck Sharp & Dohme Co., 1 Merck Drive, P.O. Box 100, Whitehouse Station, NJ 08889.

Georgetown University Medical Center, 3300 Whitehaven Street NW, Suite 4100 - Milton Harris Bldg. Washington, DC 20007.

出版信息

J Diabetes Complications. 2014 Sep-Oct;28(5):621-6. doi: 10.1016/j.jdiacomp.2014.03.012. Epub 2014 Mar 26.

DOI:10.1016/j.jdiacomp.2014.03.012

PMID:24929797

Abstract

AIMS

Type 2 diabetes is a reported risk factor for more frequent and severe urinary tract infections (UTI). We sought to quantify the annual healthcare cost burden of UTI in type 2 diabetic patients.

METHODS

Adult patients diagnosed with type 2 diabetes were identified in MarketScan administrative claims data. UTI occurrence and costs were assessed during a 1-year period. We examined UTI-related visit and antibiotic costs among patients diagnosed with UTI, comparing those with versus without a history of UTI in the previous year (prevalent vs. incident UTI cases). We estimated the total incremental cost of UTI by comparing all-cause healthcare costs in patients with versus without UTI, using propensity score-matched samples.

RESULTS

Within the year, 8.2% (6,014/73,151) of subjects had ≥1 UTI, of whom 33.8% had a history of UTI. UTI-related costs among prevalent versus incident cases were, respectively, $603 versus $447 (p=0.033) for outpatient services, $1,607 versus $1,819 (p=NS) for hospitalizations, and $61 versus $35 (p<0.0001) for antibiotics. UTI was associated with a total all-cause incremental cost of $7,045 (95% CI: 4,130, 13,051) per patient with UTI per year.

CONCLUSIONS

UTI is common and may impose a substantial direct medical cost burden among patients with type 2 diabetes.

摘要

目的

据报道，2型糖尿病是更频繁且严重的尿路感染（UTI）的一个风险因素。我们试图量化2型糖尿病患者尿路感染的年度医疗费用负担。

方法

在MarketScan行政索赔数据中识别出诊断为2型糖尿病的成年患者。在1年期间评估尿路感染的发生情况和费用。我们检查了被诊断为尿路感染的患者中与尿路感染相关的就诊和抗生素费用，比较了上一年有尿路感染病史的患者与无尿路感染病史的患者（现患与新发尿路感染病例）。我们使用倾向评分匹配样本，通过比较有尿路感染和无尿路感染患者的全因医疗费用，估计尿路感染的总增量成本。

结果

在这一年中，8.2%（6,014/73,151）的受试者发生了≥1次尿路感染，其中33.8%有尿路感染病史。现患与新发病例的尿路感染相关费用分别为：门诊服务603美元对447美元（p = 0.033），住院1,607美元对1,819美元（p = 无显著性差异），抗生素61美元对35美元（p < 0.0001）。尿路感染与每位有尿路感染的患者每年总计7,045美元（95%置信区间：4,130，13,051）的全因增量成本相关。