Guevara-Sanginés Esther, Pérez-Rojas Diego, Nevárez-Sida Armando, Aceves Martha Alicia, Barrón-Tapia María Teresa, Abaroa-Cantú Fernando Jorge, Ancona-Castro Circe, García-Salazar María Rosario, Hernández-Rodríguez Jimena Miguel, García-Contreras Fernando, Estrada-Aguilar Lorena
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Lic. Adolfo López Mateos, Servicio de Dermatología, Ciudad de México, México.
Rev Alerg Mex. 2020 Jan-Mar;67(1):9-18. doi: 10.29262/ram.v67i1.700.
In Mexico, the economic burden of medical care for patients with atopic dermatitis is unknown.
To determine the annual direct medical costs of the treatment for patients with moderate to severe atopic dermatitis who receive medical attention at "Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado" (Institute for Social Security and Social Services for State Workers, better known as ISSSTE), as well as the main variables associated with it.
A multicenter, retrospective cohort study. Clinical records of patients with moderate to severe atopic dermatitis were reviewed and a multivariate analysis was designed by using a generalized linear model.
65 patients were included; 41 of them (63.07 %) had moderate atopic dermatitis, and 24 (36.92 %) had severe AD; 39 (60 %) of them were female patients. In groups with severe atopic dermatitis, statistically significant differences were observed in matters of the duration of the evolution of the disease, comorbidities, intense pruritus, and depression. The average annual cost of medical care for patients with moderate atopic dermatitis was 1527 ± 623 USD, and for patients with severe atopic dermatitis the cost was 9487 ± 8990 USD. Significant differences were observed in dermatology consultations, referrals, laboratory and diagnostic studies, and the number of drugs prescribed by physicians. With the multivariate analysis, it was identified that the highest cost was presented by severe patients (p = 0.0001) who were younger and had comorbidities, along with diagnosis of depression.
The severity of atopic dermatitis, the age average, the presence of comorbidities, and the diagnosis of depression are the variables with the highest association and impact on the direct cost of medical care.
在墨西哥，特应性皮炎患者的医疗经济负担尚不清楚。
确定在“国家工人社会保障和社会服务研究所”（简称ISSSTE）接受治疗的中重度特应性皮炎患者的年度直接医疗费用，以及与之相关的主要变量。
一项多中心回顾性队列研究。回顾了中重度特应性皮炎患者的临床记录，并使用广义线性模型设计了多变量分析。
纳入65例患者；其中41例（63.07%）患有中度特应性皮炎，24例（36.92%）患有重度特应性皮炎；其中39例（60%）为女性患者。在重度特应性皮炎组中，在疾病演变持续时间、合并症、剧烈瘙痒和抑郁方面观察到统计学上的显著差异。中度特应性皮炎患者的平均年度医疗费用为1527±623美元，重度特应性皮炎患者的费用为9487±8990美元。在皮肤科会诊、转诊、实验室和诊断研究以及医生开的药数量方面观察到显著差异。通过多变量分析，确定年龄较小、患有合并症且诊断为抑郁的重度患者费用最高（p = 0.0001）。
特应性皮炎的严重程度、平均年龄、合并症的存在以及抑郁诊断是与直接医疗费用关联和影响最大的变量。
