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与没有子宫肌瘤的女性相比,诊断为子宫肌瘤的女性的医疗资源利用和成本。

Healthcare resource utilization and costs among women diagnosed with uterine fibroids compared to women without uterine fibroids.

机构信息

Allergan plc , Irvine , CA , USA.

Albert Einstein College of Medicine , Bronx , NY , USA.

出版信息

Curr Med Res Opin. 2019 Nov;35(11):1925-1935. doi: 10.1080/03007995.2019.1642186. Epub 2019 Aug 22.

DOI:10.1080/03007995.2019.1642186
PMID:31290716
Abstract

To perform a retrospective, matched-cohort, longitudinal evaluation of annual pre- and post-diagnosis costs incurred among women with uterine fibroids (UF) (cases) compared to controls without UF. Data were derived from the IBM Watson Health MarketScan Commercial Claims and Encounters and Medicaid Multi-State databases. Women aged 18-64 years with ≥1 inpatient or outpatient medical claim with an initial UF diagnosis (index date) from 1 January 2010 to 31 December 2014 were included. Healthcare resource utilization (HCRU) data including pharmacy, outpatient and inpatient hospital claims were collected for 1 year pre-index and ≤5 years post-index. All-cause costs (adjusted to 2017 $US) were compared between cases and controls using multivariable regression models. Analysis included 205,098 (Commercial) and 24,755 (Medicaid) case-control pairs. HCRU and total all-cause healthcare costs were higher for cases versus controls during the pre-index year and all years post-index. Total unadjusted mean all-cause costs were $1197 higher ( < .0001; Commercial) and $2813 higher (standardized difference 0.08; Medicaid) for cases during the pre-index year. Total adjusted mean all-cause costs in the first year post-index were $14,917 for cases versus $5717 for controls in the Commercial population, and $20,244 versus $10,544, respectively, in the Medicaid population. In Years 2-5 post-index, incremental mean adjusted total costs decreased, but remained significantly higher for cases versus controls at all time points in both populations (all  < .05). Costs were higher for women with UF compared to women without UF during the pre-index year and over 5 years post-index; differences were greatest in the first year post-index.

摘要

对患有子宫肌瘤 (UF) 的女性 (病例) 和无 UF 的对照者在诊断前和诊断后每年的成本进行回顾性、匹配队列、纵向评估。数据来自 IBM Watson Health MarketScan 商业索赔和就诊记录以及 Medicaid 多州数据库。纳入年龄在 18-64 岁之间、在 2010 年 1 月 1 日至 2014 年 12 月 31 日期间有至少 1 次初始 UF 诊断 (索引日期) 的门诊或住院医疗索赔的女性。在索引前 1 年和索引后 ≤5 年收集了药房、门诊和住院医院索赔的医疗资源利用 (HCRU) 数据。使用多变量回归模型比较病例和对照组之间的全因成本 (调整为 2017 年美元)。分析包括 205098 例 (商业) 和 24755 例 (医疗补助) 病例对照。在索引前一年和所有索引后年份,病例的 HCRU 和全因医疗保健总成本均高于对照组。在索引前一年,病例的未调整全因平均总费用高出 1197 美元 ( < .0001;商业) 和 2813 美元 (标准化差异 0.08;医疗补助)。在商业人群中,病例在索引后第一年的全因调整平均总费用为 14917 美元,而对照组为 5717 美元;在 Medicaid 人群中,分别为 20244 美元和 10544 美元。在索引后 2-5 年,增量调整后总费用呈下降趋势,但在两个群体的所有时间点,病例的费用仍然明显高于对照组 (均 < .05)。在索引前一年和索引后 5 年期间,患有 UF 的女性比没有 UF 的女性的成本更高;在索引后第一年的差异最大。

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