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美国糖尿病患者肺炎的医疗利用和费用支出。

Healthcare utilisation and cost expenditures for pneumonia in individuals with diabetes mellitus in the USA.

机构信息

The University of Texas at Austin, College of Pharmacy,Austin, TX,USA.

出版信息

Epidemiol Infect. 2019 Jan;147:e212. doi: 10.1017/S0950268819000979.

Abstract

Pneumonia is one of the leading causes of hospitalisations among adults in the USA. Individuals with diabetes mellitus (DM) have been associated with increased risk for pneumonia and complications including death. The objectives of this study were to (1) compare the prevalence and healthcare utilisation patterns for pneumonia in individuals with and without DM, and (2) identify risk factors for pneumonia in those with DM. We performed a retrospective, cross-sectional analysis of the US adult population using Medical Expenditure Panel Surveys (MEPS) data from 2014. Overall, the data represented 24 million individuals with DM and 218 million without DM in the USA. The population-based rate for a pneumonia event was 34 per 1000 persons for individuals with DM and 19 per 1000 persons without DM. Compared to the non-DM group, individuals with DM were treated 1.8x, 2.6x and 1.4x more in the ED, hospital and outpatient, respectively. Furthermore, the average cost per pneumonia event was significantly higher among individuals with DM compared to non-DM in the inpatient setting ($11 931 vs. $7751; P < 0.001). Among individuals with DM, female sex, DM complications, smokers and administration of pneumococcal vaccines were significant factors associated with a pneumonia event.

摘要

肺炎是美国成年人住院的主要原因之一。患有糖尿病(DM)的个体患肺炎和并发症(包括死亡)的风险增加。本研究的目的是:(1) 比较有和没有 DM 的个体中肺炎的患病率和医疗保健利用模式,(2) 确定 DM 个体中肺炎的危险因素。我们使用 2014 年医疗支出面板调查 (MEPS) 数据对美国成年人进行了回顾性、横断面分析。总体而言,数据代表了美国 2400 万患有 DM 的个体和 2.18 亿没有 DM 的个体。DM 个体的肺炎事件人群发生率为每 1000 人 34 例,而非 DM 个体为每 1000 人 19 例。与非 DM 组相比,DM 个体在急诊室、医院和门诊的治疗次数分别多 1.8 倍、2.6 倍和 1.4 倍。此外,DM 个体的肺炎事件每例平均住院费用明显高于非 DM 个体(住院费用分别为 11931 美元和 7751 美元;P < 0.001)。在 DM 个体中,女性、DM 并发症、吸烟者和肺炎球菌疫苗接种是与肺炎事件相关的显著因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ea4/6624864/4554a6141848/S0950268819000979_fig1.jpg

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