Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.
Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands.
Endocrine. 2019 May;64(2):330-340. doi: 10.1007/s12020-019-01847-7. Epub 2019 Mar 22.
Non-functioning pituitary adenomas (NFPA) have a substantial impact on patients' health status, yet research on the extent of healthcare utilization and costs among these patients is scarce. The objective was to determine healthcare usage, associated costs, and their determinants among patients treated for an NFPA.
In a cross-sectional study, 167 patients treated for an NFPA completed four validated questionnaires. Annual healthcare utilization and associated costs were assessed through the medical consumption questionnaire (MTA iMCQ). In addition, the Leiden Bother and Needs Questionnaire for pituitary patients (LBNQ-Pituitary), Short Form-36 (SF-36), and EuroQol (EQ-5D) were administered. Furthermore, age, sex, endocrine status, treatment, and duration of follow-up were extracted from the medical records. Associations were analyzed using logistic/linear regression.
Annual healthcare utilization included: consultation of an endocrinologist (95% of patients), neurosurgeon (14%), and/or ophthalmologist (58%). Fourteen percent of patients had ≥1 hospitalization(s) and 11% ≥1 emergency room visit(s). Mean overall annual healthcare costs were € 3040 (SD 6498), highest expenditures included medication (31%), inpatient care (28%), and specialist care (17%). Factors associated with higher healthcare utilization and costs were greater self-perceived disease bother and need for support, worse mental and physical health status, younger age, and living alone.
Healthcare usage and costs among patients treated for an NFPA are substantial and were associated with self-perceived health status, disease bother, and healthcare needs rather than endocrine status, treatment, or duration of follow-up. These findings suggest that targeted interventions addressing disease bother and unmet needs in the chronic phase are needed.
无功能性垂体腺瘤（NFPA）对患者的健康状况有重大影响，但针对此类患者的医疗保健利用程度和费用的研究却很少。本研究旨在确定 NFPA 患者的医疗保健使用情况、相关费用及其决定因素。
在一项横断面研究中，167 名接受 NFPA 治疗的患者完成了四份经过验证的问卷。通过医疗消费问卷（MTA iMCQ）评估年度医疗保健利用情况和相关费用。此外，还使用了莱顿垂体患者困扰和需求问卷（LBNQ-Pituitary）、简明健康调查问卷 36 项（SF-36）和欧洲五维健康量表（EQ-5D）。此外，还从病历中提取了年龄、性别、内分泌状态、治疗和随访时间。使用逻辑/线性回归分析关联。
年度医疗保健利用情况包括：内分泌科医生（95%的患者）、神经外科医生（14%）和/或眼科医生（58%）的就诊。14%的患者至少有 1 次住院治疗，11%的患者至少有 1 次急诊就诊。总体平均年医疗保健费用为 3040 欧元（标准差 6498），最高支出包括药物（31%）、住院护理（28%）和专科护理（17%）。与更高的医疗保健利用和费用相关的因素包括更大的自我感知疾病困扰和对支持的需求、更差的心理健康和身体健康状况、更年轻的年龄和独居。
接受 NFPA 治疗的患者的医疗保健使用和费用相当高，与自我感知的健康状况、疾病困扰和医疗保健需求相关，而与内分泌状态、治疗或随访时间无关。这些发现表明，需要针对慢性病阶段的疾病困扰和未满足的需求进行有针对性的干预。
