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日本系统性红斑狼疮患者的疾病严重程度和经济负担:一项回顾性观察研究。

Disease severity and economic burden in Japanese patients with systemic lupus erythematosus: A retrospective, observational study.

作者信息

Tanaka Yoshiya, Mizukami Akiko, Kobayashi Akihiro, Ito Chie, Matsuki Taizo

机构信息

First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Fukuoka, Japan.

Vaccines Health Outcomes Department, Development and Medical Affairs Division, GlaxoSmithKline K.K., Tokyo, Japan.

出版信息

Int J Rheum Dis. 2018 Aug;21(8):1609-1618. doi: 10.1111/1756-185X.13363.

Abstract

AIM

To describe the healthcare resource utilization (HRU), direct medical costs and clinical characteristics for Japanese patients with mild, moderate or severe systemic lupus erythematosus (SLE). The primary objectives were to describe HRU and examine the direct medical costs for Japanese patients with mild, moderate, or severe SLE over the 3-year study period. Secondary objectives included recording patient demographics, clinical characteristics and frequency and cost of mild, moderate or severe flares. Exploratory objectives included a description of treatment patterns, and to explore which factors affect medical costs.

METHODS

This retrospective, observational cohort study identified patients with SLE (diagnosed April 2010 to March 2012), from the Japan Medical Data Center claims database.

RESULT

The study cohort comprised 295 patients with mild (28, 9.5%), moderate (134, 45.4%), or severe (133, 45.1%) SLE. Outpatient visits, hospitalizations and emergency room stays were experienced by 295 (100%), 116 (39.3%) and 31 (10.5%) patients, respectively, over the 3-year study period. Over the 3-year period, the mean total direct medical cost was US$27 004, and cost increased with SLE severity: mild, $5549 moderate, $15 290; and severe, $43 322 (analysis of variance, P < 0.0001). During this period, the majority of patients (282, 95.6%) experienced at least one flare episode and the mean (standard deviation) frequency was 5.5 (3.3) flares. The mean total direct medical cost per flare increased with SLE severity.

CONCLUSION

This descriptive study provides information on the economic burden and clinical characteristics of Japanese patients with SLE based on claims data; high levels of HRU and direct medical costs were exhibited, particularly in patients with moderate or severe disease.

摘要

目的

描述日本轻、中、重度系统性红斑狼疮(SLE)患者的医疗资源利用(HRU)、直接医疗费用及临床特征。主要目的是描述HRU,并研究日本轻、中、重度SLE患者在3年研究期内的直接医疗费用。次要目的包括记录患者人口统计学信息、临床特征以及轻、中、重度病情发作的频率和费用。探索性目的包括描述治疗模式,并探究哪些因素影响医疗费用。

方法

这项回顾性观察队列研究从日本医学数据中心理赔数据库中识别出2010年4月至2012年3月期间确诊的SLE患者。

结果

研究队列包括295例轻(28例,9.5%)、中(134例,45.4%)、重度(133例,45.1%)SLE患者。在3年研究期内,分别有295例(100%)、116例(39.3%)和31例(10.5%)患者有门诊就诊、住院和急诊室就诊经历。在3年期间,平均总直接医疗费用为27,004美元,费用随SLE严重程度增加而升高:轻度为5549美元,中度为15,290美元,重度为43,322美元(方差分析,P<0.0001)。在此期间,大多数患者(282例,95.6%)经历了至少一次病情发作,平均(标准差)发作频率为5.5(3.3)次。每次病情发作的平均总直接医疗费用随SLE严重程度增加而升高。

结论

这项描述性研究基于理赔数据提供了日本SLE患者经济负担和临床特征的信息;显示出较高水平的HRU和直接医疗费用,尤其是在中重度疾病患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126b/6585770/87ca2d86b1b6/APL-21-1609-g001.jpg

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