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糖尿病的医疗利用和成本与疼痛性糖尿病周围神经病变临床谱的关系

Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy.

作者信息

Sadosky Alesia, Mardekian Jack, Parsons Bruce, Hopps Markay, Bienen E Jay, Markman John

机构信息

Pfizer, Inc., New York, NY, USA.

Pfizer, Inc., New York, NY, USA.

出版信息

J Diabetes Complications. 2015 Mar;29(2):212-7. doi: 10.1016/j.jdiacomp.2014.10.013. Epub 2014 Nov 8.

Abstract

AIMS

Diabetic peripheral neuropathy (DPN) accompanied by painful symptoms is known as painful DPN (pDPN). This study characterized healthcare resource utilization and costs in patients with DPN, pDPN, and severe pDPN relative to diabetes only.

METHODS

Four adult cohorts were identified from the Humedica database: type 2 diabetes without DPN (n=288,328); DPN (n=35,050); pDPN (DPN subjects with a pain score ≥1 on a 0-10 numeric rating scale; n=3449); and severe pDPN (pain scores 7-10; n=1824). Resource utilization and costs for 12-months post-diagnosis were compared for diabetes relative to the other cohorts.

RESULTS

Demographic characteristics were different across cohorts. Relative to diabetes alone, DPN, pDPN, and severe pDPN were characterized by significantly higher proportions of patients with resource utilization for all resource categories (all P<0.0001); the highest resource use generally observed for severe pDPN. Total annual direct medical costs were $6632 for diabetes only, with costs for DPN ($12,492), pDPN ($27,931), and severe pDPN ($30,755) significantly higher (all P<0.0001); outpatient costs were consistently the primary driver of total costs.

CONCLUSIONS

Patients with DPN, pDPN, and severe pDPN had significantly greater healthcare resource utilization and costs than patients with diabetes only, with the highest burden associated with severe pDPN.

摘要

目的

伴有疼痛症状的糖尿病周围神经病变(DPN)被称为疼痛性糖尿病周围神经病变(pDPN)。本研究描述了DPN、pDPN和重度pDPN患者相对于仅患有糖尿病患者的医疗资源利用情况和成本。

方法

从Humedica数据库中确定了四个成年队列:无DPN的2型糖尿病患者(n = 288,328);DPN患者(n = 35,050);pDPN患者(在0 - 10数字评分量表上疼痛评分≥1的DPN受试者;n = 3449);以及重度pDPN患者(疼痛评分7 - 10;n = 1824)。比较了糖尿病患者与其他队列在诊断后12个月的资源利用情况和成本。

结果

各队列的人口统计学特征不同。相对于仅患有糖尿病的患者,DPN、pDPN和重度pDPN患者在所有资源类别中的资源利用比例显著更高(所有P < 0.0001);重度pDPN患者的资源使用通常最高。仅患有糖尿病的患者每年直接医疗总成本为6632美元,DPN患者(12,492美元)、pDPN患者(27,931美元)和重度pDPN患者(30,755美元)的成本显著更高(所有P < 0.0001);门诊成本始终是总成本的主要驱动因素。

结论

与仅患有糖尿病的患者相比,DPN、pDPN和重度pDPN患者的医疗资源利用和成本显著更高,重度pDPN患者的负担最重。

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