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近视性脉络膜新生血管的流行病学、治疗模式及医疗保健利用情况:一项基于人群的研究。

Epidemiology, treatment pattern and health care utilization of myopic choroidal neovascularization: a population based study.

作者信息

Yang Ming-Chin, Chen Yen-Po, Tan Elise Chia-Hui, Leteneux Claudia, Chang Erin, Chu Carol Hy, Lai Chi-Chun

机构信息

Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.

Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-Shan, 333, Taoyuan, Taiwan.

出版信息

Jpn J Ophthalmol. 2017 Mar;61(2):159-168. doi: 10.1007/s10384-016-0496-3. Epub 2017 Jan 6.

Abstract

PURPOSE

To investigate the prevalence and incidence of myopic choroidal neovascularization (CNV) in Taiwan, including the health care utilization and treatment-associated costs.

METHODS

A retrospective cohort study using existing data from the Taiwanese National Health Insurance claims database to identify patients who had a diagnosis of myopic CNV recorded from 1 January 2009 to 31 December 2011. The prevalence of myopic CNV was monitored during this period, and the frequency and cost of both treatment visits and monitoring visits were analyzed for 2 years following diagnosis.

RESULTS

The prevalence of myopic CNV was 0.017%. In total, 9068 patients with myopic CNV were identified, 12.3% (n = 1111) of whom were treated. Of those treated, 72.0% (n = 800) received intravitreal anti-vascular endothelial growth factor injections (IVI); the remainder received either photodynamic therapy with verteporfin (vPDT), laser photocoagulation, or a combination of therapies. IVI was associated with the largest number of treatment visits as well as a higher administrative (non-drug) cost per treatment visit (a mean of USD 57.18). vPDT alone was associated with a higher overall cost per treatment visit and more monitoring visits than IVI or laser photocoagulation. Costs for monitoring visits were highest for IVI.

CONCLUSIONS

The prevalence of myopic CNV was lower than that reported in previous studies, possibly because of differences in age distribution in the populations studied. The frequencies of treatment administered were similar to those reported in previous studies; however, a cost-effectiveness comparison could not be made owing to lack of data in previous studies.

摘要

目的

调查台湾地区近视性脉络膜新生血管(CNV)的患病率和发病率,包括医疗保健利用情况及治疗相关费用。

方法

一项回顾性队列研究,利用台湾国民健康保险索赔数据库中的现有数据,识别出2009年1月1日至2011年12月31日期间记录有近视性CNV诊断的患者。在此期间监测近视性CNV的患病率,并分析诊断后2年的治疗就诊和监测就诊的频率及费用。

结果

近视性CNV的患病率为0.017%。总共识别出9068例近视性CNV患者,其中12.3%(n = 1111)接受了治疗。在接受治疗的患者中,72.0%(n = 800)接受了玻璃体内抗血管内皮生长因子注射(IVI);其余患者接受了维替泊芬光动力疗法(vPDT)、激光光凝或联合治疗。IVI与治疗就诊次数最多以及每次治疗就诊的行政管理(非药物)成本较高相关(平均为57.18美元)。单独使用vPDT与每次治疗就诊的总体成本较高以及监测就诊次数多于IVI或激光光凝相关。IVI的监测就诊成本最高。

结论

近视性CNV的患病率低于先前研究报告的患病率,可能是由于所研究人群年龄分布的差异。所给予的治疗频率与先前研究报告的相似;然而,由于先前研究缺乏数据,无法进行成本效益比较。

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