Wright Melissa A, Korgenski E Kent, Bardsley Tyler, Bonkowsky Joshua L, Candee Meghan S
School of Medicine (M.A.W.), Study Design and Biostatistics Center (T.B.), Department of Biostatistics (T.B.), and Department of Pediatrics, Division of Pediatric Neurology (J.L.B., M.S.C.), University of Utah; and Intermountain Healthcare (E.K.K.), Salt Lake City.
Neurol Neuroimmunol Neuroinflamm. 2016 Dec 19;4(1):e314. doi: 10.1212/NXI.0000000000000314. eCollection 2017 Jan.
To determine the health care costs associated with pediatric multiple sclerosis (MS).
We performed a retrospective analysis of all patients with MS 18 years of age or younger who were diagnosed or treated between 2002 and 2012 in a population-based cohort. Demographics and health care costs were extracted from the Intermountain Healthcare Enterprise Data Warehouse. Patients were divided into high-cost (>84th percentile) and low-cost groups and differences in health care utilization between the groups were analyzed.
Fifty-seven pediatric patients with MS were identified. Health care costs for the cohort totaled more than $1.5 million over the 10-year period, with the top 16th percentile of patients contributing nearly two-thirds. Outpatient visits represented the majority of health care encounters and expenditures, accounting for 83.1% of total costs. Costs per encounter were highest for inpatient stays, averaging $2,924 per stay.
The burden of health care expenses for pediatric patients with MS is significant. Expenditures related to outpatient visits were the largest contributor to costs, but inpatient stays were the most costly per encounter. A small proportion of patients incurred the bulk of costs and spent significantly more time receiving care compared to the majority of patients. Avoidance of inpatient treatment and efficient outpatient management are potential areas for health care cost reduction and improvement in care.
确定与儿童多发性硬化症（MS）相关的医疗保健费用。
我们对2002年至2012年间在一个基于人群的队列中被诊断或接受治疗的所有18岁及以下的MS患者进行了回顾性分析。人口统计学和医疗保健费用数据来自山间医疗企业数据仓库。将患者分为高费用组（>第84百分位数）和低费用组，并分析两组之间医疗保健利用情况的差异。
共识别出57例儿童MS患者。在这10年期间，该队列的医疗保健费用总计超过150万美元，其中前16%的患者贡献了近三分之二的费用。门诊就诊占医疗保健接触和支出的大部分，占总费用的83.1%。住院每次的费用最高，平均每次住院费用为2924美元。
儿童MS患者的医疗保健费用负担很重。与门诊就诊相关的支出是费用的最大贡献者，但住院每次费用最高。一小部分患者承担了大部分费用，与大多数患者相比，他们接受护理的时间明显更长。避免住院治疗和高效的门诊管理是降低医疗保健费用和改善护理质量的潜在领域。
