Pepose Jay S, Sarda Sujata P, Cheng Wendy Y, McCormick Nora, Cheung Hoi Ching, Bobbili Priyanka, Joseph Corey, Duh Mei Sheng
Pepose Vision Institute, Chesterfield, MO, USA.
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA.
Clin Ophthalmol. 2020 Feb 11;14:377-387. doi: 10.2147/OPTH.S233486. eCollection 2020.
To assess the direct and indirect costs of infectious conjunctivitis and quantify medical costs due to conjunctivitis transmission in families.
In this retrospective claims analysis from the OptumHealth Care Solutions, Inc. database (1998-2016), beneficiaries with or without at least one diagnosis of infectious conjunctivitis were identified. Direct and indirect costs (in 2016 US$) during the 60 days post conjunctivitis diagnosis (or imputed date for controls) were compared using cost differences in linear regressions. For transmission cost analysis, the total cost of each conjunctivitis episode was the sum of the primary episode (seed patient) and the secondary episode (infected family members) costs. A generalized estimating equation model adjusted for seed patient characteristics was used to assess the impact of number and rate of transmissions on episode cost.
Health care resource utilization and direct costs were significantly higher for patients with conjunctivitis (n=1,002,188) versus controls (n=4,877,210): 1.67 all-cause visits per person per month (PPPM) versus 0.79 visits PPPM, respectively; total mean direct cost of $396.04 PPPM versus $289.63 PPPM, respectively. The cost of medically related absenteeism was $105.42 (95% confidence interval [CI], $104.18-$106.75) higher for patients with conjunctivitis than for controls. Episode cost, without transmission due to seed patient, was $669.43 (95% CI, $654.67-$684.85); it increased with each additional infected family member and with increased infection transmission time between family members.
Conjunctivitis was associated with a notable economic burden in terms of direct medical costs and medically related absenteeism. Family health care costs increased with transmission time and with each family member infected with conjunctivitis.
评估感染性结膜炎的直接和间接成本,并量化家庭中因结膜炎传播导致的医疗成本。
在这项来自OptumHealth Care Solutions公司数据库(1998 - 2016年)的回顾性索赔分析中,确定了至少有一次感染性结膜炎诊断的受益人和无该诊断的受益人。使用线性回归中的成本差异比较结膜炎诊断后60天内(或对照组的推算日期)的直接和间接成本(以2016年美元计)。对于传播成本分析,每个结膜炎发作的总成本是原发性发作(传染源患者)和继发性发作(受感染家庭成员)成本的总和。使用针对传染源患者特征进行调整的广义估计方程模型来评估传播数量和传播率对发作成本的影响。
与对照组(n = 4,877,210)相比,结膜炎患者(n = 1,002,188)的医疗资源利用和直接成本显著更高:每人每月全因就诊次数分别为1.67次和0.79次;平均直接总成本分别为每人每月396.04美元和289.63美元。与对照组相比,结膜炎患者与医疗相关的旷工成本高出105.42美元(95%置信区间[CI],104.18 - 106.75美元)。在无传染源患者传播的情况下,发作成本为669.43美元(95% CI,654.67 - 684.85美元);随着每增加一名受感染家庭成员以及家庭成员之间感染传播时间的增加,发作成本会增加。
结膜炎在直接医疗成本和与医疗相关的旷工方面带来了显著的经济负担。家庭医疗成本随着传播时间以及每个感染结膜炎的家庭成员数量的增加而增加。