Division of Rheumatology, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, 200 First Avenue SW, Rochester, MN, 55905, USA.
Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Lung. 2017 Aug;195(4):411-418. doi: 10.1007/s00408-017-0012-7. Epub 2017 Apr 29.
There is little information about healthcare utilization for sarcoidosis. This study examined need for hospitalization as a measure of healthcare burden in this disease.
A cohort of Olmsted County, Minnesota residents diagnosed with sarcoidosis between January 1, 1976 and December 31, 2013 was identified using the resources of the Rochester Epidemiology Project. Diagnosis was made based on individual medical record review. For each sarcoidosis subject, one sex- and age-matched comparator without sarcoidosis was randomly selected from the same population. Data on hospitalizations were retrieved electronically from billing data of the Mayo Clinic, the Olmsted Medical Center, and their affiliated hospitals. These data were available from 1987 to 2015. Subjects who died or emigrated from Olmsted County prior to 1987 were excluded.
332 incident cases of sarcoidosis and 342 comparators were included. Hospitalization rates were significantly higher among patients with sarcoidosis than comparators [rate ratio (RR) 1.37; 95% confidence interval (CI) 1.24-1.52]. Analysis based on sex revealed a significantly increased rate among females (RR 1.60; 95% CI 1.40-1.82) but not among males (RR 1.06; 95% CI 0.91-1.25). The overall age- and sex-adjusted rates of hospitalization were stable from 1987 to 2015 for both cases and comparators. The average length of stay was similar (4.6 and 4.4 days for sarcoidosis and non-sarcoidosis hospitalizations, respectively, p = 0.87).
In this population, patients with sarcoidosis had a significantly higher rate of hospitalization than patients without sarcoidosis, driven by higher rates in females.
关于结节病的医疗保健利用情况的信息很少。本研究检查了住院作为衡量该病医疗负担的指标。
使用罗切斯特流行病学项目的资源,确定了明尼苏达州奥姆斯特德县在 1976 年 1 月 1 日至 2013 年 12 月 31 日期间诊断患有结节病的居民队列。根据个人病历审查做出诊断。对于每个结节病患者,从同一人群中随机选择一名无结节病的性别和年龄匹配对照者。从梅奥诊所、奥姆斯特德医疗中心及其附属医院的计费数据中以电子方式检索住院数据。这些数据可追溯至 1987 年至 2015 年。1987 年前在奥姆斯特德县死亡或移民的患者被排除在外。
纳入了 332 例结节病和 342 名对照者。结节病患者的住院率明显高于对照者[发病率比(RR)1.37;95%置信区间(CI)1.24-1.52]。基于性别的分析显示,女性的发病率显著增加(RR 1.60;95% CI 1.40-1.82),而男性则没有(RR 1.06;95% CI 0.91-1.25)。无论是病例还是对照者,1987 年至 2015 年期间,年龄和性别调整后的住院率总体保持稳定。平均住院时间相似(结节病和非结节病住院分别为 4.6 和 4.4 天,p=0.87)。
在本人群中,与无结节病患者相比,结节病患者的住院率明显更高,女性的住院率更高。