Wu Ning, Yu Yanni F, Chuang Chien-Chia, Wang Rosa, Benjamin Nicole N, Coultas David B
Evidera , Lexington, MA , USA.
J Med Econ. 2015 Apr;18(4):249-57. doi: 10.3111/13696998.2014.991789. Epub 2015 Feb 2.
Few studies have characterized healthcare resource utilization among patients with idiopathic pulmonary fibrosis. The objective of this study is to assess healthcare resource utilization among patients with idiopathic pulmonary fibrosis as compared to members without this condition.
Patients newly diagnosed with idiopathic pulmonary fibrosis were identified from a national administrative claims database (2006-2011) as having ≥ 2 claims with idiopathic fibrosing alveolitis, or ≥ 1 claim with idiopathic fibrosing alveolitis and ≥ 1 claim with post-inflammatory pulmonary fibrosis (earliest claim with idiopathic fibrosing alveolitis denoted the index date), a procedure of lung biopsy or high-resolution computed tomography within ± 90 days of the index date, 12-month pre-index continuous enrollment, plus ≥ 2 confirmatory idiopathic fibrosing alveolitis diagnoses after the procedure. For each idiopathic pulmonary fibrosis patient, three members without the condition were matched by age/gender/region/payer type. Demographic/clinical characteristics were measured during the 1-year pre-index period. Healthcare resource utilization was assessed by quarter during 1-year pre- and post-index periods. Generalized estimating equation models controlling for patient characteristics were constructed to estimate adjusted post-index healthcare resource utilization.
In total, 1735 patients with idiopathic pulmonary fibrosis and 5205 without (mean age = 71.5 years; 46.1% female) were included. Adjusted results revealed idiopathic pulmonary fibrosis patients were more likely to use healthcare resources than members without the condition 1-year post-index (number of hospitalizations, emergency room visits, and outpatients visits: 0.63 vs 0.31, 0.62 vs 0.48, and 5.7 vs 3.1 per person-year, respectively).
Healthcare resource utilization is considerably higher among patients with idiopathic pulmonary fibrosis than members without the condition. Effective treatments for patients with idiopathic pulmonary fibrosis are needed to help reduce burden of healthcare resource use.
很少有研究对特发性肺纤维化患者的医疗资源利用情况进行描述。本研究的目的是评估特发性肺纤维化患者与无此病的人群相比的医疗资源利用情况。
从一个全国性行政索赔数据库（2006 - 2011年）中识别出新诊断为特发性肺纤维化的患者，这些患者有≥2次特发性纤维性肺泡炎索赔记录，或≥1次特发性纤维性肺泡炎索赔记录且≥1次炎症后肺纤维化索赔记录（最早的特发性纤维性肺泡炎索赔记录为索引日期），在索引日期前后±90天内进行肺活检或高分辨率计算机断层扫描的程序，索引日期前连续12个月参保，加上程序后≥2次确诊的特发性纤维性肺泡炎诊断。对于每例特发性肺纤维化患者，按年龄/性别/地区/支付方类型匹配3名无此病的人群。在索引日期前1年期间测量人口统计学/临床特征。在索引日期前和后的1年期间按季度评估医疗资源利用情况。构建控制患者特征的广义估计方程模型以估计索引后调整后的医疗资源利用情况。
总共纳入了1735例特发性肺纤维化患者和5205例无此病的患者（平均年龄 = 71.5岁；46.1%为女性）。调整后的结果显示，索引后1年，特发性肺纤维化患者比无此病的人群更有可能使用医疗资源（住院次数、急诊室就诊次数和门诊就诊次数：分别为每人每年0.63次对0.31次、0.62次对0.48次和5.7次对3.1次）。
特发性肺纤维化患者的医疗资源利用比无此病的人群高得多。需要有效的特发性肺纤维化治疗方法来帮助减轻医疗资源使用负担。
