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子宫内膜异位症确诊前后女性的医疗保健利用情况及费用:索赔数据库的纵向分析

Healthcare utilization and costs in women diagnosed with endometriosis before and after diagnosis: a longitudinal analysis of claims databases.

作者信息

Fuldeore Mahesh, Yang Hongbo, Du Ella Xiaoyan, Soliman Ahmed M, Wu Eric Q, Winkel Craig

机构信息

AbbVie, Inc., North Chicago, Illinois.

Analysis Group, Inc., Boston, Massachusetts.

出版信息

Fertil Steril. 2015 Jan;103(1):163-71. doi: 10.1016/j.fertnstert.2014.10.011. Epub 2014 Nov 15.

Abstract

OBJECTIVE

To assess healthcare resource utilization and costs during the 5 years before and 5 years after diagnosis among women with endometriosis, in comparison with women without endometriosis.

DESIGN

Longitudinal, retrospective, case-control study.

SETTING

None.

PATIENT(S): A total of 37,570 matched pairs of women with and without (controls) endometriosis were identified from the Truven Health MarketScan claims database (2000-2010).

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Annual healthcare resource utilization and costs (in 2010 US dollars) were evaluated for the 5 years before and 5 years after diagnosis.

RESULT(S): Mean patient age at index (first diagnosis) date was 36.4 years for endometriosis patients and controls. Endometriosis patients had a higher utilization of outpatient and emergency room services during each pre- and postindex year, and a higher utilization of inpatient services during the last preindex year and all 5 postindex years. Total costs were highest in the first postindex year for endometriosis patients, reaching $13,199, compared with $3,747 for controls. Annual costs were significantly higher for patients than controls during each pre- and postindex year; overall, the cost difference was $26,305 over 10 years: $7,028 in the 5 years before diagnosis and $19,277 in the 5 years after diagnosis.

CONCLUSION(S): Endometriosis poses a significantly high economic burden, both before and after diagnosis. The highest resource utilization and costs experienced by endometriosis patients occur in the first year after diagnosis.

摘要

目的

评估子宫内膜异位症女性患者诊断前5年及诊断后5年的医疗资源利用情况和费用,并与无子宫内膜异位症的女性进行比较。

设计

纵向、回顾性病例对照研究。

地点

无。

患者

从Truven Health MarketScan理赔数据库(2000 - 2010年)中识别出总共37570对匹配的患有和未患有(对照)子宫内膜异位症的女性。

干预措施

无。

主要观察指标

评估诊断前5年及诊断后5年的年度医疗资源利用情况和费用(以2010年美元计)。

结果

子宫内膜异位症患者和对照在索引(首次诊断)日期的平均患者年龄为36.4岁。子宫内膜异位症患者在索引前后各年的门诊和急诊服务利用率较高,在索引前最后一年和索引后所有5年的住院服务利用率较高。子宫内膜异位症患者在索引后第一年的总费用最高,达到13199美元,而对照为3747美元。在索引前后各年,患者的年度费用均显著高于对照;总体而言,10年的费用差异为26305美元:诊断前5年为7028美元,诊断后5年为19277美元。

结论

子宫内膜异位症在诊断前后均带来显著的高经济负担。子宫内膜异位症患者最高的资源利用和费用发生在诊断后的第一年。

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