Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA.
Department of Biostatistics, Duke University School of Medicine, Durham, NC, USA.
Disabil Health J. 2019 Jul;12(3):431-436. doi: 10.1016/j.dhjo.2019.01.007. Epub 2019 Jan 21.
More children with spina bifida (SB) are surviving into adulthood. Unfortunately, little data exist regarding the economic implications of modern SB care.
We examined economic data from two national databases to estimate the annual nationwide hospital and emergency charges of SB from 2006-14.
We analyzed the 2006-2014 Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS). SB patients were defined using ICD-9-CM codes. Demographic and charge data were obtained from each database. Multiple imputation was used to estimate missing data (1.6% for NIS and 22% in NEDS). The principal outcomes were mean, median, and total charges for encounters each year.
There were 725,646 encounters for individuals with SB between 2006 and 2014. The average age of captured SB patients who were admitted to a hospital or seen in an ER was 29 years. In 2014, the median charge for inpatient encounters was $31,071 (IQR: $15,947, $63,063) and for ER encounters was $2407.02 (IQR: $1321.91, $4211.35). In total, the sum of charges from all SB-related admissions in 2014 was $1,862,016,217 (95% CI: $1.69 billion, $2.03 billion), while the sum of charges of all SB-related ER encounters in 2014 was $176,843,522 (95% CI: $158 million, $196 million). There was a steady increase in charges over the study period.
Charges for SB-related inpatient and emergency care in the US in 2014 was in excess of $2 billion in contrast to $1.2 billion in 2006, after adjusting for inflation; this is an impressively high figure for a relatively small number of patients.
患有脊柱裂（SB）的儿童有更多的人能够存活到成年期。不幸的是，目前关于现代 SB 护理的经济影响的数据很少。
我们通过分析两个全国性数据库中的经济数据，估计了 2006-14 年 SB 患者的全国性医院和急诊费用。
我们分析了 2006-2014 年全国住院患者样本（NIS）和全国急诊患者样本（NEDS）。使用 ICD-9-CM 代码定义 SB 患者。从每个数据库中获取人口统计学和费用数据。采用多重插补法估计缺失数据（NIS 为 1.6%，NEDS 为 22%）。主要结果是每年就诊的患者的平均、中位数和总费用。
2006 年至 2014 年期间，有 725646 例 SB 患者接受了治疗。被收入医院或急诊室的 SB 患者的平均年龄为 29 岁。2014 年，住院患者的中位数费用为 31071 美元（IQR：15947 美元，63063 美元），急诊患者的中位数费用为 2407.02 美元（IQR：1321.91 美元，4211.35 美元）。2014 年，所有与 SB 相关的住院治疗的费用总计为 1862016217 美元（95%CI：16.9 亿美元，20.3 亿美元），而 2014 年所有与 SB 相关的急诊治疗的费用总计为 176843522 美元（95%CI：1.58 亿美元，1.96 亿美元）。研究期间，费用呈稳步上升趋势。
2014 年，美国与 SB 相关的住院和急诊治疗费用经通胀调整后超过 20 亿美元，而 2006 年为 12 亿美元；对于相对较少的患者来说，这是一个令人印象深刻的数字。
