Han Guang-Ming, Han Xiao-Feng
Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, 214122, People's Republic of China.
Nebraska Department of Health and Human Services, Lincoln, NE, 68509, USA.
Clin Rheumatol. 2016 Jun;35(6):1483-92. doi: 10.1007/s10067-016-3277-y. Epub 2016 Apr 23.
This study aims to examine the associations between comorbid conditions and healthcare utilization, medical charges, or mortality of patients with rheumatoid arthritis (RA). Nebraska state emergency department (ED) discharge, hospital discharge, and death certificate data from 2007 to 2012 were used to study the comorbid conditions of patients with RA. RA was defined using the standard International Classification of Diseases (ICD-9-CM 714 or ICD-10-CM M05, M06, and M08). There were more comorbid conditions in patients with RA than in patients without RA. Comorbid conditions were majorly related to healthcare utilization and mortality of patients with RA. In addition to injury, fracture, sprains, and strains, symptoms of cardiovascular and digestive systems, respiratory infection, and chronic obstructive pulmonary disease (COPD) were common comorbid conditions for ED visits. In addition to joint replacement and fracture, infections, COPD and cardiovascular comorbidities were common comorbid conditions for hospitalizations. Cardiovascular, cerebrovascular, and respiratory comorbidities, dementia, malignant neoplasm, and diabetes mellitus were common comorbid conditions for deaths of patients with RA. In addition, the numbers of comorbid conditions were significantly associated with the length of hospital stay and hospital charges for patients with RA. The findings in this study indicated that comorbid conditions are associated with healthcare utilization, medical charges, and mortality of patients with RA.
本研究旨在探讨类风湿关节炎（RA）患者的合并症与医疗服务利用、医疗费用或死亡率之间的关联。利用2007年至2012年内布拉斯加州急诊科出院、医院出院及死亡证明数据，研究RA患者的合并症情况。RA采用标准国际疾病分类（ICD - 9 - CM 714或ICD - 10 - CM M05、M06和M08）进行定义。RA患者的合并症比非RA患者更多。合并症主要与RA患者的医疗服务利用和死亡率相关。除损伤、骨折、扭伤和拉伤外，心血管和消化系统症状、呼吸道感染及慢性阻塞性肺疾病（COPD）是急诊科就诊的常见合并症。除关节置换和骨折外，感染、COPD及心血管合并症是住院的常见合并症。心血管、脑血管和呼吸道合并症、痴呆、恶性肿瘤及糖尿病是RA患者死亡的常见合并症。此外，合并症的数量与RA患者的住院时间和住院费用显著相关。本研究结果表明，合并症与RA患者的医疗服务利用、医疗费用及死亡率相关。
