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先兆子痫给美国医疗保健系统带来的短期成本。

Short-term costs of preeclampsia to the United States health care system.

作者信息

Stevens Warren, Shih Tiffany, Incerti Devin, Ton Thanh G N, Lee Henry C, Peneva Desi, Macones George A, Sibai Baha M, Jena Anupam B

机构信息

Precision Health Economics, Los Angeles, CA.

Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA; California Perinatal Quality Care Collaborative, Palo Alto, CA.

出版信息

Am J Obstet Gynecol. 2017 Sep;217(3):237-248.e16. doi: 10.1016/j.ajog.2017.04.032. Epub 2017 Jul 11.

Abstract

BACKGROUND

Preeclampsia is a leading cause of maternal morbidity and mortality and adverse neonatal outcomes. Little is known about the extent of the health and cost burden of preeclampsia in the United States.

OBJECTIVE

This study sought to quantify the annual epidemiological and health care cost burden of preeclampsia to both mothers and infants in the United States in 2012.

STUDY DESIGN

We used epidemiological and econometric methods to assess the annual cost of preeclampsia in the United States using a combination of population-based and administrative data sets: the National Center for Health Statistics Vital Statistics on Births, the California Perinatal Quality Care Collaborative Databases, the US Health Care Cost and Utilization Project database, and a commercial claims data set.

RESULTS

Preeclampsia increased the probability of an adverse event from 4.6% to 10.1% for mothers and from 7.8% to 15.4% for infants while lowering gestational age by 1.7 weeks (P < .001). Overall, the total cost burden of preeclampsia during the first 12 months after birth was $1.03 billion for mothers and $1.15 billion for infants. The cost burden per infant is dependent on gestational age, ranging from $150,000 at 26 weeks gestational age to $1311 at 36 weeks gestational age.

CONCLUSION

In 2012, the cost of preeclampsia within the first 12 months of delivery was $2.18 billion in the United States ($1.03 billion for mothers and $1.15 billion for infants), and was disproportionately borne by births of low gestational age.

摘要

背景

子痫前期是孕产妇发病和死亡以及不良新生儿结局的主要原因。在美国,关于子痫前期的健康和成本负担程度知之甚少。

目的

本研究旨在量化2012年美国子痫前期对母亲和婴儿造成的年度流行病学和医疗保健成本负担。

研究设计

我们使用流行病学和计量经济学方法,结合基于人群的数据集和行政数据集来评估美国子痫前期的年度成本,这些数据集包括:国家卫生统计中心的出生统计数据、加利福尼亚围产期质量护理协作数据库、美国医疗保健成本和利用项目数据库以及一个商业索赔数据集。

结果

子痫前期使母亲发生不良事件的概率从4.6%增加到10.1%,使婴儿发生不良事件的概率从7.8%增加到15.4%,同时孕周缩短1.7周(P <.001)。总体而言,出生后前12个月子痫前期的总成本负担,母亲为10.3亿美元,婴儿为11.5亿美元。每个婴儿的成本负担取决于孕周,从孕26周时的15万美元到孕36周时的1311美元不等。

结论

2012年,在美国分娩后的前12个月内,子痫前期的成本为21.8亿美元(母亲为10.3亿美元,婴儿为11.5亿美元),且低孕周出生儿承担的负担不成比例。

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