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在私人保险人群中,骨关节炎患者的年龄和关节位置对医疗资源利用和成本的影响。

Healthcare resource utilization and costs by age and joint location among osteoarthritis patients in a privately insured population.

机构信息

a AbbVie, Inc. , North Chicago , IL , USA.

b Analysis Group, Inc. , Boston , MA , USA.

出版信息

J Med Econ. 2017 Dec;20(12):1299-1306. doi: 10.1080/13696998.2017.1377717. Epub 2017 Sep 26.

Abstract

AIMS

To compare healthcare resource utilization and costs between patients aged 18-64 years with osteoarthritis (OA) and matched controls without OA in a privately insured population.

METHODS

Patients with OA were selected from de-identified US-based employer claims (Q1:1999-Q3:2011). The index date was defined as the first OA diagnosis indicated by ICD-9-CM codes. One year before and after the index date were defined as the baseline and study periods, respectively. A second OA diagnosis during the study period was also required. Patients with OA were matched one-to-one on age, gender, index date, and minimum length of follow-up to controls without OA. Baseline characteristics and study period resource utilization and costs (2016 USD) were compared between cohorts.

RESULTS

This study identified 199,539 patients with OA (knee: 87,271, hip: 19,953, hand: 15,670, spine: 12,496). The average age was 54 years, and 58% were female. OA patients had higher healthcare resource utilization than matched controls in inpatient, emergency room, and outpatient settings (p < .001 for all). Further, patients with OA had 4-times the excess total medical costs of their matched controls ($14,521 vs $3,629; p < .001). Patients with hip OA had the highest medical costs among all joint locations. Outpatient and pharmacy costs were similar among patients with knee, hip, and hand OA, but higher in patients with spine OA. In sub-group analyses, older patients (45-64 years old) had higher costs.

LIMITATIONS

This sample, obtained using claims data, only includes patients who were actively seeking care for OA and were likely symptomatic. Asymptomatic patients would likely not be captured in this analysis.

CONCLUSIONS

Patients with OA incur greater healthcare resource utilization and costs than patients without OA, with substantial variation by joint location.

摘要

目的

比较 18-64 岁患有骨关节炎(OA)和匹配的无 OA 对照组患者的医疗资源利用和成本。

方法

从美国基于雇主索赔的去识别数据中选择 OA 患者(Q1:1999 年-Q3:2011 年)。索引日期定义为 ICD-9-CM 代码指示的首次 OA 诊断。索引日期前一年和后一年分别定义为基线期和研究期。研究期间还需要进行第二次 OA 诊断。OA 患者按照年龄、性别、索引日期和无 OA 对照组的最小随访时间进行一对一匹配。比较两组患者的基线特征和研究期间的资源利用和成本(2016 年美元)。

结果

本研究共纳入 199,539 例 OA 患者(膝部:87,271 例,髋部:19,953 例,手部:15,670 例,脊柱:12,496 例)。平均年龄为 54 岁,58%为女性。OA 患者在住院、急诊室和门诊环境中的医疗资源利用均高于匹配的对照组(所有 P 值均<0.001)。此外,OA 患者的总医疗费用比对照组多 4 倍(14,521 美元对 3,629 美元;P<0.001)。所有关节部位中,髋部 OA 患者的医疗费用最高。膝、髋和手部 OA 患者的门诊和药房费用相似,但脊柱 OA 患者的费用更高。在亚组分析中,年龄较大的患者(45-64 岁)的费用更高。

局限性

本研究样本来自索赔数据,仅包括积极寻求 OA 治疗且可能有症状的患者。在这项分析中,可能没有捕捉到无症状患者。

结论

与无 OA 患者相比,OA 患者的医疗资源利用和成本更高,且不同关节部位存在显著差异。

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