Ostermann Julia K, Witt Claudia M, Reinhold Thomas
Institute for Social Medicine, Epidemiology and Health Economics, Charité - University Medical Center, Berlin, Germany.
University of Maryland School of Medicine, Center for Integrative Medicine, Baltimore, Maryland, United States of America.
PLoS One. 2017 Sep 15;12(9):e0182897. doi: 10.1371/journal.pone.0182897. eCollection 2017.
This study aimed to provide a long-term cost comparison of patients using additional homeopathic treatment (homeopathy group) with patients using usual care (control group) over an observation period of 33 months.
Health claims data from a large statutory health insurance company were analysed from both the societal perspective (primary outcome) and from the statutory health insurance perspective (secondary outcome). To compare costs between patient groups, homeopathy and control patients were matched in a 1:1 ratio using propensity scores. Predictor variables for the propensity scores included health care costs and both medical and demographic variables. Health care costs were analysed using an analysis of covariance, adjusted for baseline costs, between groups both across diagnoses and for specific diagnoses over a period of 33 months. Specific diagnoses included depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.
Data from 21,939 patients in the homeopathy group (67.4% females) and 21,861 patients in the control group (67.2% females) were analysed. Health care costs over the 33 months were 12,414 EUR [95% CI 12,022-12,805] in the homeopathy group and 10,428 EUR [95% CI 10,036-10,820] in the control group (p<0.0001). The largest cost differences were attributed to productivity losses (homeopathy: EUR 6,289 [6,118-6,460]; control: EUR 5,498 [5,326-5,670], p<0.0001) and outpatient costs (homeopathy: EUR 1,794 [1,770-1,818]; control: EUR 1,438 [1,414-1,462], p<0.0001). Although the costs of the two groups converged over time, cost differences remained over the full 33 months. For all diagnoses, homeopathy patients generated higher costs than control patients.
The analysis showed that even when following-up over 33 months, there were still cost differences between groups, with higher costs in the homeopathy group.
本研究旨在对接受额外顺势疗法治疗的患者(顺势疗法组)和接受常规护理的患者(对照组)在33个月的观察期内进行长期成本比较。
从社会角度(主要结果)和法定健康保险角度(次要结果)分析了一家大型法定健康保险公司的健康索赔数据。为了比较患者组之间的成本,使用倾向得分以1:1的比例对顺势疗法患者和对照患者进行匹配。倾向得分的预测变量包括医疗保健成本以及医疗和人口统计学变量。使用协方差分析对医疗保健成本进行分析,并针对33个月期间各诊断组以及特定诊断组之间的基线成本进行调整。特定诊断包括抑郁症、偏头痛、过敏性鼻炎、哮喘、特应性皮炎和头痛。
分析了顺势疗法组21,939名患者(67.4%为女性)和对照组21,861名患者(67.2%为女性)的数据。顺势疗法组33个月的医疗保健成本为12,414欧元[95%置信区间12,022 - 12,805],对照组为10,428欧元[95%置信区间10,036 - 10,820](p<0.0001)。最大的成本差异归因于生产力损失(顺势疗法:6,289欧元[6,118 - 6,460];对照:5,498欧元[5,326 - 5,670],p<0.0001)和门诊成本(顺势疗法:1,794欧元[1,770 - 1,818];对照:1,438欧元[1,414 - 1,462],p<0.0001)。尽管两组成本随时间趋于一致,但在整个33个月期间成本差异仍然存在。对于所有诊断,顺势疗法患者产生的成本均高于对照患者。
分析表明,即使在33个月的随访期内,两组之间仍存在成本差异,顺势疗法组的成本更高。