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美国过度活动膀胱(OAB)的经济负担及其对与其他慢性、年龄相关的合并症相关成本的影响。

The economic burden of overactive bladder (OAB) and its effects on the costs associated with other chronic, age-related comorbidities in the United States.

机构信息

Truven Health Analytics, an IBM Company, Bethesda, Maryland.

Astellas, Inc., Northbrook, Illinois.

出版信息

Neurourol Urodyn. 2018 Jun;37(5):1641-1649. doi: 10.1002/nau.23513. Epub 2018 Feb 21.

Abstract

AIMS

The prevalence of OAB increases with age and is associated with several chronic comorbidities. However, the impact of OAB on the healthcare costs of patients with such comorbidities is not well-understood. This study aimed to quantify the impact of OAB on healthcare costs and assess the potential moderating effects of OAB on the costs of patients with chronic comorbidities.

METHODS

Adults with evidence of OAB/OAB-related therapy between 1/1/2008-12/31/2013 were identified from two large, administrative claims databases. Per-patient-per-month (PPPM) expenditures for OAB cases were estimated and compared to those of propensity score-matched subjects without OAB. Costs were modeled using ordinary least squares regression including main effects and interactions of chronic depression, dementia, diabetes, hypertension, and osteoporosis with OAB. Values for the comparisons were calculated on the original dollar scale using smearing estimators.

RESULTS

A total of 110 059 pairs of OAB cases and matched non-OAB controls were identified. The mean, multivariable-adjusted, PPPM all-cause costs of OAB cases from the model without interactions were $3003, compared to $1123 for matched controls (P < 0.0001). In the model assessing the interactions of chronic comorbidities with OAB, those OAB patients with comorbid depression, dementia, diabetes, hypertension, and osteoporosis incurred significantly higher costs than controls with these comorbidities. The synergistic effect of these interactions was estimated to be $95-$574 PPPM.

CONCLUSIONS

Within this US-based population, the healthcare costs of OAB patients were more than 2.5 times those of similar patients without OAB. Additionally, patients with OAB and chronic, age-related comorbidities incurred higher healthcare costs than non-OAB controls with the same comorbidities.

摘要

目的

OAB 的患病率随年龄增长而增加,并与多种慢性合并症相关。然而,OAB 对患有此类合并症的患者的医疗保健成本的影响尚未得到充分了解。本研究旨在量化 OAB 对医疗保健成本的影响,并评估 OAB 对慢性合并症患者成本的潜在调节作用。

方法

从两个大型行政索赔数据库中确定了 2008 年 1 月 1 日至 2013 年 12 月 31 日期间有 OAB/OAB 相关治疗证据的成年人。估计了每位患者每月(PPPM)的 OAB 病例支出,并与没有 OAB 的倾向得分匹配受试者进行了比较。使用普通最小二乘回归对成本进行建模,包括慢性抑郁症、痴呆症、糖尿病、高血压和骨质疏松症与 OAB 的主要影响和相互作用。使用平滑估计器在原始美元尺度上计算了比较值。

结果

共确定了 110059 对 OAB 病例和匹配的非 OAB 对照。来自无相互作用模型的多变量调整后 PPPM 全因成本,OAB 病例为 3003 美元,匹配对照为 1123 美元(P<0.0001)。在评估慢性合并症与 OAB 相互作用的模型中,患有合并症抑郁症、痴呆症、糖尿病、高血压和骨质疏松症的 OAB 患者的成本明显高于患有这些合并症的对照患者。这些相互作用的协同效应估计为 95-574 美元/月。

结论

在这项基于美国的研究中,OAB 患者的医疗保健成本是无 OAB 相似患者的 2.5 倍以上。此外,患有 OAB 和慢性、与年龄相关的合并症的患者比患有相同合并症的非 OAB 对照患者的医疗保健成本更高。

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