Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
Clin Nutr. 2018 Dec;37(6 Pt A):2149-2155. doi: 10.1016/j.clnu.2017.10.014. Epub 2017 Oct 31.
BACKGROUND & AIMS: Vitamin D deficiency is associated with higher morbidity. However, there is few data regarding the effect of vitamin D deficiency on health care costs. This study examined the cross-sectional and longitudinal associations between the serum 25-hydroxy vitamin D concentration (25OHD) and direct health care costs and hospitalization in two independent samples of the general population in North-Eastern Germany.
We studied 7217 healthy individuals from the 'Study of Health in Pomerania' (SHIP n = 3203) and the 'Study of Health in Pomerania-Trend' (SHIP-Trend n = 4014) who had valid 25OHD measurements and provided data on annual total costs, outpatient costs, hospital stays, and inpatient costs. The associations between 25OHD concentrations (modelled continuously using factional polynomials) and health care costs were examined using a generalized linear model with gamma distribution and a log link. Poisson regression models were used to estimate relative risks of hospitalization.
In cross-sectional analysis of SHIP-Trend, non-linear associations between the 25OHD concentration and inpatient costs and hospitalization were detected: participants with 25OHD concentrations of 5, 10 and 15 ng/ml had 226.1%, 51.5% and 14.1%, respectively, higher inpatient costs than those with 25OHD concentrations of 20 ng/ml (overall p-value = 0.001) in multivariable models.
We found a relation between lower 25OHD concentrations and increased inpatient health care costs and hospitalization. Our results thus indicate an influence of vitamin D deficiency on health care costs in the general population.
维生素 D 缺乏与更高的发病率有关。然而，关于维生素 D 缺乏对医疗保健费用的影响的数据很少。本研究在德国东北部的两个独立的一般人群样本中，考察了血清 25-羟维生素 D 浓度（25OHD）与直接医疗保健费用和住院治疗之间的横断面和纵向关联。
我们研究了来自“波罗的海健康研究”（SHIP n=3203）和“波罗的海健康研究趋势”（SHIP-Trend n=4014）的 7217 名健康个体，这些个体具有有效的 25OHD 测量值，并提供了关于年度总费用、门诊费用、住院时间和住院费用的数据。使用具有伽马分布和对数链接的广义线性模型，使用分数多项式连续模拟 25OHD 浓度，检查 25OHD 浓度与医疗保健费用之间的关联。使用泊松回归模型估计住院的相对风险。
在 SHIP-Trend 的横断面分析中，检测到 25OHD 浓度与住院费用和住院之间的非线性关联：25OHD 浓度为 5、10 和 15ng/ml 的参与者的住院费用分别比 25OHD 浓度为 20ng/ml 的参与者高 226.1%、51.5%和 14.1%（多变量模型中的总体 p 值=0.001）。
我们发现 25OHD 浓度较低与住院医疗保健费用和住院增加之间存在关系。因此，我们的结果表明维生素 D 缺乏对一般人群的医疗保健费用有影响。
